Provider Demographics
NPI:1518308170
Name:DR.BADAWY PAIN & SPINE CENTER, LLC
Entity Type:Organization
Organization Name:DR.BADAWY PAIN & SPINE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMR
Authorized Official - Middle Name:H
Authorized Official - Last Name:BADAWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-985-4700
Mailing Address - Street 1:4351 HUNTERS PARK LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7614
Mailing Address - Country:US
Mailing Address - Phone:407-574-3129
Mailing Address - Fax:407-985-4702
Practice Address - Street 1:4351 HUNTERS PARK LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7614
Practice Address - Country:US
Practice Address - Phone:407-574-3129
Practice Address - Fax:407-985-4702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 110154261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015074100Medicaid
FLHP271AMedicare UPIN