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General NPI Number Information
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NPI Number | 1235727884
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Entity Type | Organization
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Legal Business Name | FLORIDA PAIN & REHABILITATION ASSOCIATES INC
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 9400 BONITA BEACH RD #101
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City | BONITA SPRINGS
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State | FL
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Zip | 34135
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Country | US
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Telephone | 239-333-1177
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Fax | 239-939-4733
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Provider Business Mailing Address
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Address Line | 4960 SW 72ND AVE STE 405
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City | MIAMI
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State | FL
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Zip | 33155-5506
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Country | US
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Telephone | 469-458-9222
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Fax | 540-918-7222
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Authorized Official
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Title or Position | RCM MANAGER
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Name | SHANEKA TINCH
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Credential |
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Telephone | 469-458-9222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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