Provider Demographics
NPI:1932401924
Name:ADVANCED PAIN MANAGEMENT AND ANESTHESIA
Entity type:Organization
Organization Name:ADVANCED PAIN MANAGEMENT AND ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:XAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-678-8522
Mailing Address - Street 1:1050 SE MONTEREY RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4512
Mailing Address - Country:US
Mailing Address - Phone:772-678-8522
Mailing Address - Fax:
Practice Address - Street 1:1050 SE MONTEREY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4512
Practice Address - Country:US
Practice Address - Phone:772-678-8522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain