SPACE COAST SPINE LLC. (NPI# 1558911818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558911818 |
| Entity Type | Organization |
| Organization Name | SPACE COAST SPINE LLC. |
| Practice Address |
1402 Dunlawton Ave Ste 2b Port Orange FL 32127-2917 |
| Practice Telephone | 3862276688 |
| Mailing Telephone | 3862276688 |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-12-04 |
| Authorized Official Name | MICHAEL SAMBURSKY (OWNER) |
| Authorized Official Telephone | 3862817900 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
1402 DUNLAWTON AVE STE 2B |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32127-2917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952918179 | Karen Lugo Morales | Massage Therapist | 1394 Dunlawton Ave, Apartment 505, Port Orange, FL 32127 | 2020-09-30 |
| 1265952568 | Compass Nutrition LLC | Dietitian, Registered | 840 Angelina Court, Port Orange, FL 32127 | 2017-06-27 |
| 1942730544 | Ambili Gopinathan Nair | Nurse Anesthetist, Certified Registered | 6216 Morning Drive, Port Orange, FL 32127 | 2017-06-15 |
| 1649707993 | Jill Lynn Sheldon | Social Worker | 3959 South Nova Road, Suiteb15, Port Orange, FL 32127 | 2017-05-17 |
| 1003350620 | Irene A Zachry | Interpreter | 6239 Yellowstone Dr. Port Orange Fl, Port Orange, FL 32127 | 2016-12-16 |
| 1427460328 | Jonathan Ivan Rodriguez Arocho | Chiropractor | 940 Village Trail, Unit 4-105, Port Orange, FL 32127 | 2014-05-27 |
| 1982015913 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1208 Dunlawton Ave, Port Orange, FL 32127 | 2014-05-13 |
| 1699105288 | Counseling & Consultation, Corp. | Early Intervention Provider Agency | 3959 S. Nova Rd., Suite 14, Port Orange, FL 32127 | 2013-11-18 |
| 1427484773 | Usv Optical Inc. | Technician/Technologist | 1800 Dunlawton Ave., Port Orange, FL 32127 | 2013-09-18 |
| 1104194018 | Jinny E Ruhlman | Marriage & Family Therapist | 4725 Dixie Dr, Ponce Inlet, FL 32127 | 2011-12-06 |
| Find all providers in zip 32127 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114571163 | Nicole Troyer | Chiropractor | 4462 Tumbleweed Trl, Port Orange, FL 32127-4984 | 2019-07-29 |
| 1336603083 | Michael Sambursky | Chiropractor | 1402 Dunlawton Ave # 2b, Port Orange, FL 32127-2917 | 2019-01-28 |
| 1871069732 | Coastal City Chiropractic Center LLC | Chiropractor | 4550 Clyde Morris Blvd Ste D, Port Orange, FL 32129-4080 | 2018-10-18 |
| 1639654387 | Jennifer Chelsie Demaio | Chiropractor | 4550 Clyde Morris Blvd, Ste D, Port Orange, FL 32129-4080 | 2018-09-28 |
| 1134601602 | Kathleen Ann Rooney | Chiropractor | 813 Little Town Rd, Port Orange, FL 32127-9232 | 2018-08-31 |
| 1417463894 | Lowe Chiropractic and Wellness Center | Chiropractor | 3780 S Nova Rd Ste 6, Port Orange, FL 32129-4203 | 2017-12-20 |
| 1427563915 | Kristal Xiomara Perez | Chiropractor | 862 Stonybrook Cir, Port Orange, FL 32127-4211 | 2017-12-06 |
| 1912410838 | Nicolle J Schultze | Chiropractor | 3959 S Nova Rd Ste 9, Port Orange, FL 32127-4900 | 2017-11-14 |
| 1023544640 | Garrett Chiropractic LLC | Chiropractor | 1409 Royal Grove Ln, Port Orange, FL 32129-8998 | 2017-05-02 |
| 1942750807 | Bryan Thomas Call | Chiropractor | 841 Chickadee Dr, Port Orange, FL 32127-4770 | 2016-10-04 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32127 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.