| The Right Spinal Clinic Inc | |
|
4019 W Waters Ave Ste E Tampa FL 33614-2333 | |
| (813) 392-2164 | |
| (813) 392-2165 |
| Full Name | The Right Spinal Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4019 W Waters Ave Ste E, Tampa, Florida |
| Authorized Official Name and Position | Lianny Jimenez-urdanivia (OWNER) |
| Authorized Official Contact | 8133922164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Right Spinal Clinic Inc 4019 W Waters Ave Ste E Tampa FL 33614-2333 Ph: (813) 392-2164 | The Right Spinal Clinic Inc 4019 W Waters Ave Ste E Tampa FL 33614-2333 Ph: (813) 392-2164 |
| NPI Number | 1619487246 |
|---|---|
| Provider Enumeration Date | 10/10/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9436575438 |
|---|---|
| Medicare Enrollment ID | O20200821000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619487246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | HCC11165 (Florida) | Primary |
| Provider Name | Stephen Diamantides |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1508993114 PECOS PAC ID: 9931196300 Enrollment ID: I20040803001619 |
| Provider Name | Douglas Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750474375 PECOS PAC ID: 4183755473 Enrollment ID: I20100630000678 |
| Provider Name | Mohsin Ansari |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538516398 PECOS PAC ID: 0547548760 Enrollment ID: I20161024000097 |
| Provider Name | Marie Confident Barroso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487189049 PECOS PAC ID: 5193096113 Enrollment ID: I20170809000584 |
| Provider Name | Celena Vinent Carbonell |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770043507 PECOS PAC ID: 7719218296 Enrollment ID: I20200824000269 |
| Provider Name | Wendy Thompson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760996805 PECOS PAC ID: 9335409069 Enrollment ID: I20200904000109 |
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