Basic

LBN: Brain And Spine Instate For Children
Basic is an health care organization with primary practice located at 2813 S Hiawassee Rd Suite 201, Orlando FL 32835-6300. The organization recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as the primary health care specialty. Brain And Spine Instate For Children can be contacted via phone (407) 378-5100, or through Johnson, Keyne K via phone (407) 378-5100.

Contact Information

Primary practice address
2813 S Hiawassee Rd Suite 201 Orlando FL 32835-6300
Phone: (407) 378-5100
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Keyne K Doctor of Medicine (MD)
Phone: (407) 378-5100

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X ME 102412 Florida

Profile Details

NPI number 1104166735
LBN Legal business name Brain And Spine Instate For Children
DBA Doing business as Basic
Authorized official Johnson, Keyne K Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 19th, 2013
Last updated Feb 19th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104166735 NPPES
Florida MEDICAID 000384900

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