MEDICARE: FLORIDA PAIN & REHABILITATION INSTITUTE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1134709074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA PAIN & REHABILITATION INSTITUTE INC

Provider Business Mailing Address
First Line	:	11350 MCCORMICK RD.
Second Line	:	EXECUTIVE PLAZA 1, SUITE 501
City	:	HUNT VALLEY
State	:	MD
Zip	:	21031
Country	:	US
Telephone Number	:	678-841-7135
Fax Number	:	678-841-7223

Provider Business Practice Location Address
First Line	:	978 INTERNATIONAL PKWY STE 1440
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5233
Country	:	US
Telephone Number	:	407-624-5028
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	CHERIAN K SAJAN
Credential	:
Telephone Number	:	678-841-7135

Provider Enumeration Date	:	04/14/2021
Last Update Date	:	04/14/2021

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