Healthcare Provider Details

I. General information

NPI: 1144971136
Provider Name (Legal Business Name): AI PAIN INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2022
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4897 S JOG RD STE A
GREENACRES FL
33467-5000
US

IV. Provider business mailing address

4897 S JOG RD STE A
GREENACRES FL
33467-5000
US

V. Phone/Fax

Practice location:
  • Phone: 561-445-2886
  • Fax: 561-434-9174
Mailing address:
  • Phone: 561-445-2886
  • Fax: 561-434-9174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BART G GATZ
Title or Position: OWNER
Credential: MD
Phone: 561-641-0089