Provider Demographics
NPI:1962704213
Name:PAIN RELIEF CENTER USA CORP
Entity type:Organization
Organization Name:PAIN RELIEF CENTER USA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-596-6644
Mailing Address - Street 1:8100 SW 81ST DR
Mailing Address - Street 2:290
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6603
Mailing Address - Country:US
Mailing Address - Phone:305-596-6644
Mailing Address - Fax:305-596-6646
Practice Address - Street 1:8100 SW 81ST DR
Practice Address - Street 2:290
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-6603
Practice Address - Country:US
Practice Address - Phone:305-596-6644
Practice Address - Fax:305-596-6646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8541261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center