MEDICARE: PRECISION PAIN, 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
1	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1154066942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION PAIN, LLC

Provider Business Mailing Address
First Line	:	1470-A ROYAL PALM BEACH BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411
Country	:	US
Telephone Number	:	561-422-1819
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 HARVARD CIR STE 700
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1989
Country	:	US
Telephone Number	:	561-422-1819
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIMOTHY DECANIO
Credential	:	DC
Telephone Number	:	561-422-1819

Provider Enumeration Date	:	05/05/2022
Last Update Date	:	06/27/2023

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Directions to “PRECISION PAIN, LLC ” Practice Location

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