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General NPI Number Information
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NPI Number | 1285182659
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Entity Type | Organization
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Legal Business Name | FLORIDA PAIN SPECIALISTS PLLC
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 4100 SOUTHPOINT DR E STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8710
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Country | US
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Telephone | 46-475-2669
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Fax | 904-770-5594
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Provider Business Mailing Address
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Address Line | 4100 SOUTHPOINT DR E STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8710
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Country | US
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Telephone | 46-475-2669
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Fax | 904-770-5594
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BRIDGET ROBERTS
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Credential |
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Telephone | 904-509-8739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | PA9105187
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | ME117856
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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