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NPI Code Detail

MEDICARE: DREAM MEDICAL LLC

MEDICARE: DREAM MEDICAL LLC
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
1208VP0014XInterventional Pain Medicine Physician

General Provider Information

NPI Number : 1144575135
Entity Type Code : Organization
Provider Name (Legal Business Name) : DREAM MEDICAL LLC
Provider Business Mailing Address
First Line : 2103 JENKS AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4511
Country : US
Telephone Number : 850-763-8000
Fax Number : 850-785-1122
Provider Business Practice Location Address
First Line : 4295 3RD AVE
Second Line :
City : MARIANNA
State : FL
Zip : 32446-2120
Country : US
Telephone Number : 850-763-8000
Fax Number : 850-785-1122
Authorized Official
Title or Position : PRESIDENT
Name : DR. AARON J. SHORES
Credential : MD
Telephone Number : 850-763-8000
Provider Enumeration Date : 07/17/2012
Last Update Date : 04/22/2022

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Directions to “DREAM MEDICAL LLC ” Practice Location

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