MEDICARE: A PAIN CLINIC OF WEST PALM BEACH INC

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	174400000X	Specialist

General Provider Information

NPI Number	:	1568477230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A PAIN CLINIC OF WEST PALM BEACH INC

Provider Business Mailing Address
First Line	:	1325 S CONGRESS AVE
Second Line	:	SUITE206
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5876
Country	:	US
Telephone Number	:	561-740-7130
Fax Number	:	561-740-7180

Provider Business Practice Location Address
First Line	:	1325 S CONGRESS AVE
Second Line	:	SUITE206
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-5876
Country	:	US
Telephone Number	:	561-740-7130
Fax Number	:	561-740-7180

Authorized Official
Title or Position	:	PARTNER
Name	:	MR. JOSEPH WAYNE STOWERS
Credential	:	RN
Telephone Number	:	561-740-7130

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	08/22/2020

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