Provider Demographics
NPI:1821292996
Name:ADVANCE PAIN MANAGEMENT OF FLORIDA INC
Entity Type:Organization
Organization Name:ADVANCE PAIN MANAGEMENT OF FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:G
Authorized Official - Last Name:VENORYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-694-3775
Mailing Address - Street 1:9526 NE 2ND AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2750
Mailing Address - Country:US
Mailing Address - Phone:305-694-3775
Mailing Address - Fax:305-694-3697
Practice Address - Street 1:9526 NE 2ND AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2750
Practice Address - Country:US
Practice Address - Phone:305-694-3775
Practice Address - Fax:305-694-3697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4416426207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261858300Medicaid
FL38491OtherBCBS
FL38491OtherBCBS