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NPI Code Detail

MEDICARE: UNITED PAIN AND SPINE INSTITUTE LLC

MEDICARE: UNITED PAIN AND SPINE INSTITUTE LLC
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
12081P0004XSpinal Cord Injury Medicine Physician
22081P0301XBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
32081S0010XSports Medicine (Physical Medicine & Rehabilitation) Physician
4208VP0014XInterventional Pain Medicine Physician
5208100000XPhysical Medicine & Rehabilitation Physician
62081N0008XNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
72081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194345520
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNITED PAIN AND SPINE INSTITUTE LLC
Provider Business Mailing Address
First Line : 10175 FORTUNE PKWY UNIT 803
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-6754
Country : US
Telephone Number : 904-718-6929
Fax Number : 904-201-4057
Provider Business Practice Location Address
First Line : 10175 FORTUNE PKWY UNIT 803
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-6754
Country : US
Telephone Number : 904-718-6929
Fax Number : 904-201-4057
Authorized Official
Title or Position : PRESIDENT
Name : HAITAO ZHANG
Credential : MD
Telephone Number : 904-718-6929
Provider Enumeration Date : 04/27/2020
Last Update Date : 02/22/2022

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Directions to “UNITED PAIN AND SPINE INSTITUTE LLC ” Practice Location

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