Provider Demographics
NPI:1316931603
Name:ALL SAINTS PAIN MANAGEMENT PA
Entity type:Organization
Organization Name:ALL SAINTS PAIN MANAGEMENT PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PREDIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:SZYDLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-597-3060
Mailing Address - Street 1:PO BOX 1626
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-1626
Mailing Address - Country:US
Mailing Address - Phone:352-873-0516
Mailing Address - Fax:352-873-9726
Practice Address - Street 1:11377 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-5409
Practice Address - Country:US
Practice Address - Phone:352-597-3060
Practice Address - Fax:352-597-3077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61327261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME61327Medicare UPIN