Provider Demographics
NPI:1316199243
Name:COMPREHENSIVE PAIN CENTER OF SARASOTA INC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN CENTER OF SARASOTA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MYRDALIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ-RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-539-6360
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-0039
Mailing Address - Country:US
Mailing Address - Phone:941-539-6360
Mailing Address - Fax:941-870-0958
Practice Address - Street 1:1921 WALDEMERE ST
Practice Address - Street 2:607
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2943
Practice Address - Country:US
Practice Address - Phone:941-539-6360
Practice Address - Fax:941-870-0958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96703207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty