Organization

Interventional Spine And Pain Institute Llc

Interventional Pain Medicine Physician in Palm Bay, FL(View on Map)

Legal Business Name

Interventional Spine And Pain Institute Llc

NPI Number

1396526901

NPI Type

Organization

Enumeration Date

10/10/2023

Contact
Information

Purpose

Mailing
Location

Address

777 37TH ST STE C101
5200 BABCOCK ST NE STE 111

City

Vero Beach
Palm Bay

State

FL
FL

Postal Code

32960-7301
32905-4639

Country

US
US

Telephone Number

(772) 360-1997
(772) 360-1997

Authorized Official

Name

Phaedra Shudra

Title or Position

CREDENTIALING AND CONTRACTING SPECI

Telephone Number

(813) 785-4861

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/27/2024

Provider Address

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