Provider Demographics
NPI:1043218076
Name:PAIN MEDICINE SOLUTIONS
Entity Type:Organization
Organization Name:PAIN MEDICINE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-595-4681
Mailing Address - Street 1:8603 S DIXIE HWY
Mailing Address - Street 2:SUITE 401
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7807
Mailing Address - Country:US
Mailing Address - Phone:305-595-4681
Mailing Address - Fax:305-273-9584
Practice Address - Street 1:8603 S DIXIE HWY
Practice Address - Street 2:SUITE 401
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-7807
Practice Address - Country:US
Practice Address - Phone:305-595-4681
Practice Address - Fax:305-273-9584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2020-08-22
Deactivation Date:2005-07-18
Deactivation Code:
Reactivation Date:2006-02-14
Provider Licenses
StateLicense IDTaxonomies
FLME26578174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty