Healthcare Provider Details

I. General information

NPI: 1659791051
Provider Name (Legal Business Name): FLORIDA PAIN & REHABILITATION INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 01/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 SW 2ND AVE SUITE A
OCALA FL
34471-8179
US

IV. Provider business mailing address

5365 W ATLANTIC AVE SUITE 504
DELRAY BEACH FL
33484-8172
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-0322
  • Fax: 352-369-0325
Mailing address:
  • Phone: 561-241-9300
  • Fax: 561-241-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME109651
License Number StateFL

VIII. Authorized Official

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