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General NPI Number Information
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NPI Number | 1487097556
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Entity Type | Organization
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Legal Business Name | PAIN AND SPINE CENTERS OF FLORIDA, LLC
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 8136 CENTRALIA CT SUITE 103
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City | LEESBURG
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State | FL
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Zip | 34788-3757
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Country | US
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Telephone | 352-343-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 8136 CENTRALIA CT SUITE 103
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City | LEESBURG
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State | FL
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Zip | 34788-3757
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Country | US
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Telephone | 352-343-6900
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MR. SEAN MCLIN
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Credential |
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Telephone | 941-312-2831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | ME100408
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | ME99661
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License Number State | FL
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