360 ORTHO AND SPINE LLC (NPI# 1972062685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972062685 |
| Entity Type | Organization |
| Organization Name | 360 ORTHO AND SPINE LLC |
| Practice Address |
11809 N Dale Mabry Hwy Tampa FL 33618-3505 |
| Practice Telephone | 8333674968 |
| Practice Fax Number | 8333674968 |
| Mailing Telephone | 8333674968 |
| Mailing Fax Number | 8333674968 |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-07-26 |
| Authorized Official Name | JULIE BARTLETT (ADMINSTRATOR) |
| Authorized Official Telephone | 8333674968 |
| Is Organization Subpart | Y |
| Parent Organization Name | 360 ORTHO AND SPINE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians |
| Street Address |
11809 N DALE MABRY HWY |
| City | TAMPA |
| State | FL |
| Zip Code | 33618-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770582355 | Frederick J Mcclimans | Neuromusculoskeletal Medicine, Sports Medicine | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2005-07-18 |
| 1295336196 | Garrett Adam Dietz | Physical Therapist | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2020-11-06 |
| 1093214736 | Burke Collins Therapy, Inc | Physical Therapist | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2018-02-08 |
| 1952635724 | Megan M Kise | Physician Assistant | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2009-09-28 |
| 1861621583 | Katherine Ellen Holeman | Physical Therapist | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2009-07-02 |
| 1437342847 | Grace Angela Levy-clarke | Ophthalmology | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2007-08-20 |
| 1841354578 | Frederick J Mcclimans Do Pa | Orthopaedic Surgery | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2006-12-20 |
| 1689787160 | Tampa Bay Podiatry Associates Pa | Podiatrist | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2006-08-17 |
| 1770502015 | Ira David Shandles | Podiatrist | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2006-07-18 |
| 1962452649 | Stefan A Prada | Orthopaedic Surgery | 11809 N Dale Mabry Hwy, Tampa, FL 33618-3505 | 2006-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714130 | Virgin Mary's Pharmacy | Pharmacy | 14606 N Dale Mabry, Tampa, FL 33618 | 2020-03-05 |
| 1801378252 | Leah Rae Petit | Nurse Practitioner | 3505, 11809 N Dale Mabry Hwy, Tampa, FL 33618 | 2018-09-02 |
| 1265921100 | Almighty Home Healthcare Services, Inc. | Home Health | 16614 N. Dale Mabry Hwy, Tampa, FL 33618 | 2018-05-07 |
| 1972016368 | Pepe C Mcneal | Specialist | 15241 North Dalemabry Ave, Sola Salons (studio #14, Tampa, FL 33618 | 2017-11-08 |
| 1760919179 | Sara Ashley Carr | Counselor | 10014 N Dale Mabry Hwy Ste 216, Tampa, FL 33618 | 2017-05-16 |
| 1073975231 | National Vision, Inc. | Technician/Technologist | 10934 N Dale Mabry Hwy, Carrollwood, FL 33618 | 2016-03-25 |
| 1003209792 | Tampa General Medical Group Inc | Internal Medicine | 3419 N Lakeview Dr, Tampa, FL 33618 | 2015-03-05 |
| 1114205648 | Liberty Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 3653 Madaca Ln, Tampa, FL 33618 | 2011-08-02 |
| 1386938215 | David Leonardo Higuera | Pharmacist | 2901 W Bush Blvd, Suite 104, Tampa, FL 33618 | 2011-06-08 |
| 1922303973 | Kimberly Lynne Little | Social Worker | 3044 W. Bearss Avenue, Tampa, FL 33618 | 2011-01-24 |
| Find all providers in zip 33618 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376079848 | Farhan Siddiqi, Md Pa | Orthopaedic Surgery | 701 N West Shore Blvd, Tampa, FL 33609-1122 | 2017-05-03 |
| 1881022903 | Spine Specialists of America LLC | Orthopaedic Surgery | 13035 W Linebaugh Ave Ste 101f, Tampa, FL 33626-4481 | 2013-10-29 |
| 1700100179 | Westchase Sports Medicine Orthopaedics, LLC. | Orthopaedic Surgery | 11301 Countryway Blvd, Tampa, FL 33626-2610 | 2010-03-15 |
| 1851453609 | Robbert C Nucci | Orthopaedic Surgery | 6322 Gunn Hwy, Tampa, FL 33625-4122 | 2006-12-15 |
| 1154875284 | Tampa Back Institute Pllc | Orthopaedic Surgery | 6918 Gunn Hwy Ste C, Tampa, FL 33625-3853 | 2016-08-05 |
| 1194173260 | Joseph Spine, Pa | Orthopaedic Surgery | 2727 W Mlk Blvd, Ste 590, Tampa, FL 33607-6383 | 2016-05-31 |
| 1225434293 | National Medical Practices of Florida Pllc | Orthopaedic Surgery | 4730 N Habana Ave, Suite 300, Tampa, FL 33614-7163 | 2014-11-18 |
| 1013334655 | Gulfcoast Spine Institute, Pa | Orthopaedic Surgery | 4211 W Boy Scout Blvd, Suite 400, Tampa, FL 33607-5724 | 2014-03-20 |
| 1225454283 | Gulfcoast Spine Institute, Pa | Orthopaedic Surgery | 4211 W Boy Scout Blvd, Suite 400, Tampa, FL 33607-5724 | 2014-03-13 |
| 1164707782 | Spine & Orthopedic Center, P.a. | Orthopaedic Surgery | 812 W Dr Martin Luther King Jr Blvd, Suite 201, Tampa, FL 33603-3338 | 2011-10-14 |
| Find all providers in TAMPA | ||||
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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.