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General NPI Number Information
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NPI Number | 1457408791
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Entity Type | Organization
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Legal Business Name | MERIDIAN PAIN AND DIAGNOSTICS
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 401 S.W. 42 AVE SUITE 200
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City | CORAL GABLES
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State | FL
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Zip | 33134-1938
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Country | US
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Telephone | 305-448-6166
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Fax | 305-448-6150
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Provider Business Mailing Address
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Address Line | 401 S.W. 42 AVENUE SUITE 200
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City | CORAL GABLES
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State | FL
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Zip | 33134-1938
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Country | US
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Telephone | 305-448-6166
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Fax | 305-448-6150
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Authorized Official
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Title or Position | CEO
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Name | RONALD FREEMAN DE MEO
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Credential | M.D.
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Telephone | 954-448-6166
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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 | ME55849
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License Number State | FL
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