Provider Demographics
NPI:1003352592
Name:PAINALGIA RELIEF CENTER LLC
Entity Type:Organization
Organization Name:PAINALGIA RELIEF CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:THIERRY
Authorized Official - Last Name:SAINT-ELIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-531-8069
Mailing Address - Street 1:PO BOX 720696
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32872-0696
Mailing Address - Country:US
Mailing Address - Phone:407-531-8069
Mailing Address - Fax:407-386-3212
Practice Address - Street 1:240 MOHAWK RD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34715
Practice Address - Country:US
Practice Address - Phone:407-531-8069
Practice Address - Fax:407-386-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP3300X
261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014743000Medicaid