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NPI Code Detail

MEDICARE: PAIN MANAGEMENT CONSULTANTS OF SOUTHWEST FLORIDA, PL

MEDICARE: PAIN MANAGEMENT CONSULTANTS OF SOUTHWEST FLORIDA, PL
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) Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4DD8974OTHERFLRAILROAD MEDICARE PROV #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2611443800OTHERDOL WORKERS COMPENSATION
394990OTHERFLBC BS FLORIDA GROUP PROV

General Provider Information

NPI Number : 1649284928
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAIN MANAGEMENT CONSULTANTS OF SOUTHWEST FLORIDA, PL
Provider Business Mailing Address
First Line : PO BOX 7440
Second Line :
City : FORT MYERS
State : FL
Zip : 33911-7440
Country : US
Telephone Number : 239-333-1177
Fax Number : 239-939-4733
Provider Business Practice Location Address
First Line : 7964 SUMMERLIN LAKES DR
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-1816
Country : US
Telephone Number : 239-333-1177
Fax Number : 239-333-1169
Authorized Official
Title or Position : MANAGER
Name : DR. EUGENE D MAHANEY
Credential : MD
Telephone Number : 239-333-1177
Provider Enumeration Date : 07/29/2006
Last Update Date : 04/25/2019

Similar Medicare Providers

1669475356 — DR. GILBERTO ACOSTA M.D.
Practice Location Address:
7964 SUMMERLIN LAKES DRIVE
FORT MYERS, FL
33907-1816
Practice Phone: 239-333-1177
Practice Fax: 239-333-1169
1619978236 — DR. EUGENE D MAHANEY MD
Practice Location Address:
7964 SUMMERLIN LAKES DR
FORT MYERS, FL
33907-1816
Practice Phone: 239-333-1177
Practice Fax: 239-333-1169
1265422794 — VELIMIR A MICOVIC MD
Practice Location Address:
7964 SUMMERLIN LAKES DR
FORT MYERS, FL
33907-1816
Practice Phone: 239-333-1177
Practice Fax: 239-333-1169
1417167784 — DR. ADAM MICHAEL SHUSTER DO
Practice Location Address:
7964 SUMMERLIN LAKES DR
FORT MYERS, FL
33907-1816
Practice Phone: 239-333-1177
Practice Fax: 239-333-1169
1396066601 — DR. TIMOTHY DEVON REPLOGLE II M.D.
Practice Location Address:
7964 SUMMERLIN LAKES DR
FORT MYERS, FL
33907-1816
Practice Phone: 239-333-1177
Practice Fax: 239-333-1169
1235428947 — MRS. CHRISTINE SANCHEZ ARNP
Practice Location Address:
7964 SUMMERLIN LAKES DR
FORT MYERS, FL
33907-1816
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Practice Fax:

Directions to “PAIN MANAGEMENT CONSULTANTS OF SOUTHWEST FLORIDA, PL ” Practice Location

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