Healthcare Provider Details

I. General information

NPI: 1366975278
Provider Name (Legal Business Name): PAIN & ANESTHESIA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 MOUNT HOMER RD
EUSTIS FL
32726-6258
US

IV. Provider business mailing address

1515 CONWAY ISLE CIR
BELLE ISLE FL
32809-3301
US

V. Phone/Fax

Practice location:
  • Phone: 908-653-9399
  • Fax: 908-653-9305
Mailing address:
  • Phone: 908-653-9399
  • Fax: 908-653-9305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH STERLING
Title or Position: OWNER
Credential: MD
Phone: 908-653-9399