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General NPI Number Information
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NPI Number | 1053422725
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Entity Type | Organization
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Legal Business Name | PAIN RELIEF INSTITUTE INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/30/2010
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Provider Practice Location Address
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Address Line | 1755 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2009
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Country | US
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Telephone | 904-737-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 1755 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2009
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VPD
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Name | GERADO M FLOREZ
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Credential | MD
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Telephone | 904-421-2119
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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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