Provider Demographics
NPI:1427776616
Name:EMED PAIN MANAGEMENT INC
Entity type:Organization
Organization Name:EMED PAIN MANAGEMENT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-513-3240
Mailing Address - Street 1:2624 ATLANTIC BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-3633
Mailing Address - Country:US
Mailing Address - Phone:904-513-3240
Mailing Address - Fax:904-398-7871
Practice Address - Street 1:2624 ATLANTIC BLVD STE 6
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3633
Practice Address - Country:US
Practice Address - Phone:904-513-3240
Practice Address - Fax:904-398-7871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty