Provider Demographics
NPI:1407901796
Name:CHARLOTTE PAIN CENTER INC
Entity Type:Organization
Organization Name:CHARLOTTE PAIN CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:E
Authorized Official - Last Name:SLEIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-629-3000
Mailing Address - Street 1:3109 TAMIAMI TRL
Mailing Address - Street 2:UNIT 3
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8046
Mailing Address - Country:US
Mailing Address - Phone:941-629-3000
Mailing Address - Fax:941-629-6711
Practice Address - Street 1:3109 TAMIAMI TRL
Practice Address - Street 2:UNIT 3
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8046
Practice Address - Country:US
Practice Address - Phone:941-629-3000
Practice Address - Fax:941-629-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID