Provider Demographics
NPI:1215328943
Name:PAIN ASSOCIATION CENTER
Entity type:Organization
Organization Name:PAIN ASSOCIATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAUSTO
Authorized Official - Middle Name:P
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-699-8397
Mailing Address - Street 1:1800 SW 1ST ST STE 310
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1964
Mailing Address - Country:US
Mailing Address - Phone:305-699-8397
Mailing Address - Fax:305-699-8397
Practice Address - Street 1:1800 SW 1ST ST STE 310
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1964
Practice Address - Country:US
Practice Address - Phone:305-699-8397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center