Healthcare Provider Details
I. General information
NPI: 1033026059
Provider Name (Legal Business Name): COMPREHENSIVE ARTHRITIS SPINE AND PAIN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 PLANTATION ISLAND DR S STE 402B
SAINT AUGUSTINE FL
32080-3118
US
IV. Provider business mailing address
1301 PLANTATION ISLAND DR S STE 402B
SAINT AUGUSTINE FL
32080-3118
US
V. Phone/Fax
- Phone: 904-325-9420
- Fax:
- Phone: 904-325-9420
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADNAN
FARUQI
Title or Position: MANAGER
Credential: MD
Phone: 312-952-4422