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General NPI Number Information
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NPI Number | 1710389234
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Entity Type | Organization
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Legal Business Name | READY PAIN MANAGEMENT, LLC
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 2451 COUNTRY PLACE BLVD BUILDING D, SUITE 101, 102
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City | TRINITY
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State | FL
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Zip | 34655-1163
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Country | US
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Telephone | 727-264-8803
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Fax | 727-264-8804
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Provider Business Mailing Address
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Address Line | 1300 FISHING LAKE DR
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City | ODESSA
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State | FL
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Zip | 33556-4005
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Country | US
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Telephone | 813-600-0252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS EUGENE BOLER
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Credential | M.D.
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Telephone | 813-600-0252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME91494
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License Number State | FL
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