MEDICARE: ADVANCED PAIN MANAGEMENT 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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1114702362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PAIN MANAGEMENT INC

Provider Business Mailing Address
First Line	:	27810 SUMMERGATE BLVD
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-6919
Country	:	US
Telephone Number	:	813-388-2948
Fax Number	:	813-388-6827

Provider Business Practice Location Address
First Line	:	780 DUNLAWTON AVE STE 103
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-4252
Country	:	US
Telephone Number	:	386-671-0600
Fax Number	:	386-677-6631

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MAULIK K BHALANI
Credential	:	MD
Telephone Number	:	813-388-2948

Provider Enumeration Date	:	08/28/2023
Last Update Date	:	01/23/2025

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