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NPI Code Detail

MEDICARE: PRC ASSOCIATES LLC

MEDICARE: PRC ASSOCIATES 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
1208VP0000XPain Medicine 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 : 1457480444
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRC ASSOCIATES LLC
Provider Business Mailing Address
First Line : 1671 N CLYDE MORRIS BLVD
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32117-5590
Country : US
Telephone Number : 386-274-2977
Fax Number : 386-317-5164
Provider Business Practice Location Address
First Line : 2720 REBECCA LN
Second Line : SUITE 104
City : ORANGE CITY
State : FL
Zip : 32763-8351
Country : US
Telephone Number : 386-456-1160
Fax Number : 386-456-1162
Authorized Official
Title or Position : OWNER
Name : DR. SANJAY BAKSHI
Credential : M.D.
Telephone Number : 386-274-2977
Provider Enumeration Date : 03/05/2007
Last Update Date : 10/08/2025

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Directions to “PRC ASSOCIATES LLC ” Practice Location

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