MEDICARE: FLORIDA PAIN & REHABILITATION 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	208100000X	Physical Medicine & Rehabilitation Physician	ME57494	FL
2	208VP0000X	Pain Medicine Physician	ME57494	FL
3	208VP0014X	Interventional Pain Medicine Physician	ME57494	FL

General Provider Information

NPI Number	:	1861612483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA PAIN & REHABILITATION INSTITUTE INC

Provider Business Mailing Address
First Line	:	5365 W ATLANTIC AVE
Second Line	:	SUITE 504
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-8172
Country	:	US
Telephone Number	:	561-241-9300
Fax Number	:	561-241-9339

Provider Business Practice Location Address
First Line	:	150 SW CHAMBER CT
Second Line	:	STE 105
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-3413
Country	:	US
Telephone Number	:	772-807-9000
Fax Number	:	772-807-9087

Authorized Official
Title or Position	:	OWNER
Name	:	CHERIAN SAJAN
Credential	:	MD
Telephone Number	:	407-622-5766

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	04/04/2016

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