Provider Demographics
NPI:1124412705
Name:PAIN RELIEVER PA
Entity Type:Organization
Organization Name:PAIN RELIEVER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:ISMAIL
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-408-0839
Mailing Address - Street 1:7900 NW 27TH AVE STE F12
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-4909
Mailing Address - Country:US
Mailing Address - Phone:850-408-0839
Mailing Address - Fax:305-691-0363
Practice Address - Street 1:7900 NW 27TH AVE STE F12
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4909
Practice Address - Country:US
Practice Address - Phone:850-408-0839
Practice Address - Fax:305-691-0363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110173207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty