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General NPI Number Information
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NPI Number | 1003182866
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Entity Type | Organization
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Legal Business Name | A NEW LIFE PAIN MANAGEMENT INC
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 40 BARKLEY CIR SUITE 3
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City | FORT MYERS
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State | FL
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Zip | 33907-4518
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Country | US
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Telephone | 239-454-7246
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Fax | 239-454-7244
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Provider Business Mailing Address
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Address Line | 40 BARKLEY CIR SUITE 3
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City | FORT MYERS
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State | FL
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Zip | 33907-4518
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Country | US
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Telephone | 239-454-7246
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Fax | 239-454-7244
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Authorized Official
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Title or Position | MD
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Name | DR. FERNANDO VALLE
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Credential |
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Telephone | 239-454-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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