Provider Demographics
NPI:1487686606
Name:PAIN CARE SPECIALISTS OF THE PALM BEACHES INC
Entity Type:Organization
Organization Name:PAIN CARE SPECIALISTS OF THE PALM BEACHES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-748-7644
Mailing Address - Street 1:125 W INDIANTOWN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3539
Mailing Address - Country:US
Mailing Address - Phone:561-748-7644
Mailing Address - Fax:561-748-7645
Practice Address - Street 1:125 W INDIANTOWN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3539
Practice Address - Country:US
Practice Address - Phone:561-748-7644
Practice Address - Fax:561-748-7645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 57225207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherFEDERAL TAX ID