MEDICARE: MMCO PAIN MANAGEMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	208VP0000X	Pain Medicine Physician
3	261QP3300X	Pain Clinic/Center
4	208VP0014X	Interventional Pain Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1396404836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MMCO PAIN MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	1800 N FEDERAL HWY STE 105
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-1011
Country	:	US
Telephone Number	:	954-934-9856
Fax Number	:	954-934-9464

Provider Business Practice Location Address
First Line	:	1800 N FEDERAL HWY STE 105
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-1011
Country	:	US
Telephone Number	:	954-934-9856
Fax Number	:	954-934-9464

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARIA MERCEDES CRISTANCHO
Credential	:	MD
Telephone Number	:	954-934-9856

Provider Enumeration Date	:	12/13/2021
Last Update Date	:	01/26/2026

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1912489972 — PREFERRED THERAPY PARTNERS
Practice Location Address:

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Practice Phone: 954-952-2228
Practice Fax: 954-301-8188

Directions to “MMCO PAIN MANAGEMENT LLC ” Practice Location

Language	Start Address	Practice Location

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