Healthcare Provider Details

I. General information

NPI: 1689140410
Provider Name (Legal Business Name): FLORIDA PAIN & REHABILITATION INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2018
Last Update Date: 10/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737A SE 28TH LOOP
OCALA FL
34471-1079
US

IV. Provider business mailing address

5365 W ATLANTIC AVE STE 504
DELRAY BEACH FL
33484-8194
US

V. Phone/Fax

Practice location:
  • Phone: 888-877-3850
  • Fax: 631-329-6951
Mailing address:
  • Phone: 561-241-9300
  • Fax: 561-241-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHERIAN K SAJAN
Title or Position: OWNER
Credential: MD
Phone: 407-622-5766