Healthcare Provider Details

I. General information

NPI: 1326453747
Provider Name (Legal Business Name): PRC ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N CAUSEWAY
NEW SMYRNA BEACH FL
32169-5239
US

IV. Provider business mailing address

1671 N CLYDE MORRIS BLVD STE 100
DAYTONA BEACH FL
32117-5590
US

V. Phone/Fax

Practice location:
  • Phone: 386-410-4926
  • Fax: 386-274-2997
Mailing address:
  • Phone: 386-274-2977
  • Fax: 386-317-4164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: SANJAY BAKSHI
Title or Position: CEO
Credential: MD
Phone: 386-274-2977