Provider Demographics
NPI:1114157716
Name:PAIN CONTROL PRODUCTS MEDICAL INC.
Entity Type:Organization
Organization Name:PAIN CONTROL PRODUCTS MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAZEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-865-5575
Mailing Address - Street 1:510 DOUGLAS AVE STE 1025
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2530
Mailing Address - Country:US
Mailing Address - Phone:407-865-5575
Mailing Address - Fax:
Practice Address - Street 1:510 DOUGLAS AVE
Practice Address - Street 2:STE 1043
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2595
Practice Address - Country:US
Practice Address - Phone:407-865-5575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6404050001Medicare NSC