Organization

Pain Diagnostic & Management Center Llc

May also be knows as Pain Diagnostic & Management Center

Pain Medicine Physician in Winter Haven, FL(View on Map)

Legal Business Name

Pain Diagnostic & Management Center Llc

Also Known As

Pain Diagnostic & Management Center

NPI Number

1700988672

NPI Type

Organization

Enumeration Date

09/02/2006

Specialties

(Taxonomies)

Code

208VP0000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

321 E ROBERTSON ST
537 E CENTRAL AVE

City

Brandon
Winter Haven

State

FL
FL

Postal Code

33511-5253
33880-3054

Country

US
US

Telephone Number

(813) 685-2191
(863) 293-3656

Authorized Official

Name

Peggy Vent

Title or Position

BILLING REP

Telephone Number

(813) 685-2191

Identifiers

Identifier

593467412

Identifier State

FL

Identifier Issuer

TAX ID

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

Data last updated by provider on 04/22/2010

Provider Address

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Organization

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