MEDICARE: PAIN RELIEF INSTITUTE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1053422725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN RELIEF INSTITUTE INC

Provider Business Mailing Address
First Line	:	1755 UNIVERSITY BLVD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1755 UNIVERSITY BLVD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2009
Country	:	US
Telephone Number	:	904-737-7878
Fax Number	:

Authorized Official
Title or Position	:	VPD
Name	:	GERADO M FLOREZ
Credential	:	MD
Telephone Number	:	904-421-2119

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	08/30/2010

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Directions to “PAIN RELIEF INSTITUTE INC ” Practice Location

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