Healthcare Provider Details

I. General information

NPI: 1821789066
Provider Name (Legal Business Name): PAINCARE FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SE OSCEOLA ST STE 100
STUART FL
34994-2114
US

IV. Provider business mailing address

111 SE OSCEOLA ST STE 100
STUART FL
34994-2114
US

V. Phone/Fax

Practice location:
  • Phone: 866-228-7676
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARC LEVINE
Title or Position: MANAGER
Credential: MD
Phone: 772-485-8805