Provider Demographics
NPI:1467460063
Name:THE PAIN INSTITUTE INC
Entity Type:Organization
Organization Name:THE PAIN INSTITUTE INC
Other - Org Name:FLORIDA PAIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLOVAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-784-8211
Mailing Address - Street 1:595 N COURTENAY PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4851
Mailing Address - Country:US
Mailing Address - Phone:321-784-8211
Mailing Address - Fax:321-394-9425
Practice Address - Street 1:595 N COURTENAY PKWY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4851
Practice Address - Country:US
Practice Address - Phone:321-784-8211
Practice Address - Fax:321-394-9425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K9066Medicare PIN
5712970001Medicare NSC