Provider Demographics
NPI:1609477934
Name:PAIN INTERVENTION ASSOCIATES LLC
Entity Type:Organization
Organization Name:PAIN INTERVENTION ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-971-6096
Mailing Address - Street 1:777 37TH ST STE C103
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-7301
Mailing Address - Country:US
Mailing Address - Phone:772-971-6096
Mailing Address - Fax:949-561-4251
Practice Address - Street 1:777 37TH ST STE C103
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-7301
Practice Address - Country:US
Practice Address - Phone:561-352-7413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain