PCA INTERVENTIONAL SPINE AT MACQUARIUM NPI 1053719393

NPI Information

NPI: 1053719393
Provider Name: PCA INTERVENTIONAL SPINE AT MACQUARIUM
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
1800 PEACHTREE ST NW
SUITE 775
ATLANTA, GA
ZIP 30309
Phone: (404) 351-7654
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PCA INTERVENTIONAL SPINE AT MACQUARIUM is a pain clinic center in Atlanta, GA. PCA INTERVENTIONAL SPINE AT MACQUARIUM NPI is 1053719393. The provider is registered as an organization entity type.

The provider's business location address is:

1800 PEACHTREE ST NW
SUITE 775
ATLANTA, GA
ZIP 30309-519
Phone: (404) 351-7654
Fax: (770) 692-6082

The provider's authorized official is Rodrigo Duralde .
The authorized official title is Owner/medical Director and has the following contact phone number (404) 351-7654.

The enumeration date for this NPI number is 12/19/2014 and was last updated on 1/8/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			No
2	261QP3300X	Clinic/Center	Pain			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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