| NPI | 1154875284 |
|---|---|
| Former Legal Business Name | TAMPA BACK INSTITUTE, PLLC |
| Entity Type | Organization |
| Authorized Contact | MARK NICHOLAS PERENICH Do 813-803-0029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL OS14036) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2024-05-02 |