Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brain and Spine Instate for Children

Organization Preferred Provider Organization · NPI 1104166735

Brain and Spine Instate for Children is a Preferred Provider Organization in Orlando, Florida. Licensed in Florida. Registered with an NPI since 2013.

Licensed in
FL
In the registry since
2013

Practice location Address checks out

2813 S Hiawassee Rd Ste 201
Orlando, FL 32835-6300
Phone: (407) 378-5100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Preferred Provider Organization (primary) Taxonomy 305R00000X · Licence ME 102412 (FL)

Record details

NPI number1104166735
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Keyne Johnson — Medical Director · (407) 378-5100
Other names Basic
NPI enumeratedFebruary 19, 2013
Last updated in NPPESFebruary 19, 2013
Mailing address2813 S Hiawassee Rd, Suite 201, Orlando, FL 32835-6300

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