Provider Demographics
NPI:1528130184
Name:FLORIDA PAIN & REHABILITATION INSTITUTE INC.
Entity type:Organization
Organization Name:FLORIDA PAIN & REHABILITATION INSTITUTE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-622-5766
Mailing Address - Street 1:5365 W ATLANTIC AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8172
Mailing Address - Country:US
Mailing Address - Phone:561-241-9300
Mailing Address - Fax:561-241-9339
Practice Address - Street 1:5365 W ATLANTIC AVE
Practice Address - Street 2:SUITE 504
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8172
Practice Address - Country:US
Practice Address - Phone:561-241-9300
Practice Address - Fax:561-241-9339
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA PAIN AND REHABILITATION ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-15
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4273890002OtherMEDICARE NSC
FL4273890002OtherMEDICARE NSC
FL4273890006Medicare NSC
FL4273890004Medicare NSC
FL4273890007Medicare NSC
FL4273890012Medicare NSC
FL4273890008Medicare NSC
FL4273890009Medicare NSC
FL4273890011Medicare NSC
FL4273890003Medicare NSC
FL4273890014Medicare NSC
FL4273890016Medicare NSC
FL4273890001Medicare NSC
FL4273890010Medicare NSC
FL4273890013Medicare NSC