Provider Demographics
NPI:1518308972
Name:PAIN TREATMENT CENTERS OF FLORIDA PLLC
Entity Type:Organization
Organization Name:PAIN TREATMENT CENTERS OF FLORIDA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PYLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-861-4600
Mailing Address - Street 1:PO BOX 1629
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-1629
Mailing Address - Country:US
Mailing Address - Phone:352-861-4600
Mailing Address - Fax:352-237-5437
Practice Address - Street 1:2300 S PINE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5102
Practice Address - Country:US
Practice Address - Phone:352-861-4600
Practice Address - Fax:352-237-5437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40627208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6960560001Medicare NSC