Provider Demographics
NPI:1073409629
Name:NEXTGEN SPINE CENTER, LLC
Entity type:Organization
Organization Name:NEXTGEN SPINE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:EGUINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-809-0377
Mailing Address - Street 1:1536 KISH BLVD
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5310
Mailing Address - Country:US
Mailing Address - Phone:727-809-0377
Mailing Address - Fax:
Practice Address - Street 1:1820 WELLNESS LN BLDG 4
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5357
Practice Address - Country:US
Practice Address - Phone:878-867-7463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty