Provider Demographics
NPI:1033360441
Name:FLORIDA PAIN MANAGEMENT INSTITUTION
Entity Type:Organization
Organization Name:FLORIDA PAIN MANAGEMENT INSTITUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MP
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:RECKSIEDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-382-5439
Mailing Address - Street 1:539 S CHICKASAW TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7801
Mailing Address - Country:US
Mailing Address - Phone:407-382-5439
Mailing Address - Fax:
Practice Address - Street 1:539 S CHICKASAW TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-7801
Practice Address - Country:US
Practice Address - Phone:407-382-5439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6418111NR0400X
FLCH9595111NR0400X
FLME49756208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty