Provider Demographics
NPI:1699708693
Name:PAIN MANAGEMENT SPECIALISTS OF NORTH FLORIDA P A
Entity type:Organization
Organization Name:PAIN MANAGEMENT SPECIALISTS OF NORTH FLORIDA P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONZON
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:904-460-9555
Mailing Address - Street 1:1301 PLANTATION ISLAND DR S
Mailing Address - Street 2:SUITE 301A
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3117
Mailing Address - Country:US
Mailing Address - Phone:904-460-9555
Mailing Address - Fax:904-460-0090
Practice Address - Street 1:1301 PLANTATION ISLAND DR S STE 301A
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-3117
Practice Address - Country:US
Practice Address - Phone:904-460-9555
Practice Address - Fax:904-460-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAI043Medicare PIN
FL5819760001Medicare NSC