MEDICARE: PERSONAL INJURY PAIN FIX 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
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1912863143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL INJURY PAIN FIX LLC

Provider Business Mailing Address
First Line	:	7025 COUNTY ROAD 46A STE 1071-210
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-4721
Country	:	US
Telephone Number	:	407-738-1575
Fax Number	:	407-537-0009

Provider Business Practice Location Address
First Line	:	801 N MAGNOLIA AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-3851
Country	:	US
Telephone Number	:	866-651-4462
Fax Number	:	407-537-0009

Authorized Official
Title or Position	:	VP
Name	:	REBEKAH JACKSON
Credential	:
Telephone Number	:	407-738-1575

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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