Healthcare Provider Details

I. General information

NPI: 1528326733
Provider Name (Legal Business Name): PAIN & SPINE SPECIALISTS OF CONNECTICUT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SOUTH RD 250
FARMINGTON CT
06032-2483
US

IV. Provider business mailing address

4960 SW 72ND AVE STE 405
MIAMI FL
33155-5506
US

V. Phone/Fax

Practice location:
  • Phone: 860-674-0222
  • Fax: 860-674-0024
Mailing address:
  • Phone: 469-458-9222
  • Fax: 540-918-7202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: NICOLE FINKLE
Title or Position: RCM SR. DIRECTOR
Credential:
Phone: 719-243-9490