Provider Demographics
NPI:1053422725
Name:PAIN RELIEF INSTITUTE INC
Entity type:Organization
Organization Name:PAIN RELIEF INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VPD
Authorized Official - Prefix:
Authorized Official - First Name:GERADO
Authorized Official - Middle Name:M
Authorized Official - Last Name:FLOREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-421-2119
Mailing Address - Street 1:1755 UNIVERSITY BLVD W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1755 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2009
Practice Address - Country:US
Practice Address - Phone:904-737-7878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDF613AMedicare PIN