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General NPI Number Information
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NPI Number | 1295196459
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Entity Type | Organization
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Legal Business Name | CENTER FOR ADDICTION AND PAIN MANAGEMENT, LLC.
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 235 CITRUS TOWER BOULEVARD SUITE 104
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City | CLERMONT
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State | FL
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Zip | 34711
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Country | US
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Telephone | 352-404-8160
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Fax | 352-404-8560
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Provider Business Mailing Address
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Address Line | 235 CITRUS TOWER BOULEVARD SUITE 104
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City | CLERMONT
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State | FL
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Zip | 34711
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Country | US
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Telephone | 352-404-8160
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Fax | 352-404-8560
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Authorized Official
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Title or Position | CEO
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Name | OBED SAINT-LOUIS
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Credential | M.D.
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Telephone | 772-663-2492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | ME 126938
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License Number State | FL
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