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NPI Code Detail

MEDICARE: TOTAL PAIN RELIEF LLC

MEDICARE: TOTAL PAIN RELIEF 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
1207LP2900XPain Medicine (Anesthesiology) PhysicianME109638FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154663342
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOTAL PAIN RELIEF LLC
Provider Business Mailing Address
First Line : PO BOX 3123
Second Line :
City : ST AUGUSTINE
State : FL
Zip : 32085-3123
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10175 FORTUNE PKWY UNIT 803
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-6754
Country : US
Telephone Number : 904-374-0353
Fax Number : 904-503-0982
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. TEREL S NEWTON
Credential : MD
Telephone Number : 904-374-0353
Provider Enumeration Date : 03/26/2013
Last Update Date : 05/16/2024

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Directions to “TOTAL PAIN RELIEF LLC ” Practice Location

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