Provider Demographics
NPI:1487053492
Name:SURGICAL PAIN CONSULTANTS OF FLORIDA PLLC
Entity type:Organization
Organization Name:SURGICAL PAIN CONSULTANTS OF FLORIDA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-378-4661
Mailing Address - Street 1:10740 N CENTRAL EXPY STE 275
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2166
Mailing Address - Country:US
Mailing Address - Phone:214-378-4661
Mailing Address - Fax:888-624-8659
Practice Address - Street 1:3185 MARINERS WAY
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-9423
Practice Address - Country:US
Practice Address - Phone:214-378-4661
Practice Address - Fax:888-624-8659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 115987208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty