Healthcare Provider Details

I. General information

NPI: 1538444633
Provider Name (Legal Business Name): ANESCO INTERVENTIONAL PAIN INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2011
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 NE 20TH TER STE 303
FORT LAUDERDALE FL
33308-4510
US

IV. Provider business mailing address

PO BOX 160805
ALTAMONTE SPRINGS FL
32716-0805
US

V. Phone/Fax

Practice location:
  • Phone: 954-580-8838
  • Fax:
Mailing address:
  • Phone: 954-580-4084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD MELI
Title or Position: PRESIDENT
Credential: MD
Phone: 954-566-7588