MEDICARE: ALL SAINTS PAIN MANAGEMENT PA

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	261QP3300X	Pain Clinic/Center	ME61327	FL

General Provider Information

NPI Number	:	1316931603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL SAINTS PAIN MANAGEMENT PA

Provider Business Mailing Address
First Line	:	PO BOX 1626
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34478-1626
Country	:	US
Telephone Number	:	352-873-0516
Fax Number	:	352-873-9726

Provider Business Practice Location Address
First Line	:	11377 CORTEZ BLVD
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34613-5409
Country	:	US
Telephone Number	:	352-597-3060
Fax Number	:	352-597-3077

Authorized Official
Title or Position	:	PREDIDENT
Name	:	DR. WALTER SZYDLOWSKI
Credential	:	MD
Telephone Number	:	352-597-3060

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	08/22/2020

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