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General NPI Number Information
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NPI Number | 1700921137
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Entity Type | Organization
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Legal Business Name | NATIONAL INSTITUTE OF PAIN, INC.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 4911 VAN DYKE RD
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City | LUTZ
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State | FL
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Zip | 33558-4813
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Country | US
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Telephone | 727-251-1366
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Fax |
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Provider Business Mailing Address
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Address Line | 4911 VAN DYKE ROAD
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City | LUTZ
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State | FL
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Zip | 33558-4813
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUNIL J PANCHAL
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Credential | M.D.
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Telephone | 813-264-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME93346
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License Number State | FL
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