Provider Demographics
NPI:1194976845
Name:ADVANCED PAIN MEDICINE AND REHAB PLLC
Entity type:Organization
Organization Name:ADVANCED PAIN MEDICINE AND REHAB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALSHON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-495-1801
Mailing Address - Street 1:14000 MILITARY TRL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-2610
Mailing Address - Country:US
Mailing Address - Phone:561-495-1801
Mailing Address - Fax:561-495-4652
Practice Address - Street 1:14000 MILITARY TRL
Practice Address - Street 2:SUITE 210
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-2610
Practice Address - Country:US
Practice Address - Phone:561-495-1801
Practice Address - Fax:561-495-4652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAQ030AMedicare PIN