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NPI Code Detail

MEDICARE: PRECISION PAIN MEDICAL CENTER, LLC

MEDICARE: PRECISION PAIN MEDICAL CENTER, 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
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianME 118705FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME 118705OTHERFLLICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194251611
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRECISION PAIN MEDICAL CENTER, LLC
Provider Business Mailing Address
First Line : 6811 PORTO FINO CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4354
Country : US
Telephone Number : 239-431-4625
Fax Number :
Provider Business Practice Location Address
First Line : 6811 PORTO FINO CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4354
Country : US
Telephone Number : 239-431-4625
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. ALEXANDER J MARTINEZ
Credential : M.D.
Telephone Number : 305-979-5558
Provider Enumeration Date : 05/03/2017
Last Update Date : 05/03/2017

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Directions to “PRECISION PAIN MEDICAL CENTER, LLC ” Practice Location

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