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General NPI Number Information
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NPI Number | 1356617187
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT OF CENTRAL FLORIDA, LLC
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 9319 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32817-4110
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Country | US
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Telephone | 407-440-2919
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Fax |
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Provider Business Mailing Address
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Address Line | 9319 E COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32817-4110
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Country | US
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Telephone | 407-440-2919
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL L LE MON
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Credential | M. D.
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Telephone | 407-440-2919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | HCC8937
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | HCC8937
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License Number State | FL
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