Provider Demographics
NPI:1003073792
Name:PAIN RELIEF CENTER OF SOUTH MIAMI
Entity Type:Organization
Organization Name:PAIN RELIEF CENTER OF SOUTH MIAMI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, NMT
Authorized Official - Phone:305-273-7990
Mailing Address - Street 1:PO BOX 565567
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-5567
Mailing Address - Country:US
Mailing Address - Phone:305-273-7990
Mailing Address - Fax:
Practice Address - Street 1:7000 SW 97TH AVE
Practice Address - Street 2:SUITE 208A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1494
Practice Address - Country:US
Practice Address - Phone:305-273-7990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM 4890174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty