Provider Demographics
NPI:1831124767
Name:REHAB & PAIN MANAGEMENT SERVICES PA
Entity Type:Organization
Organization Name:REHAB & PAIN MANAGEMENT SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-278-5700
Mailing Address - Street 1:1630 MEDICAL LN
Mailing Address - Street 2:STE. A & B
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1129
Mailing Address - Country:US
Mailing Address - Phone:239-278-5700
Mailing Address - Fax:239-275-5786
Practice Address - Street 1:1630 MEDICAL LN
Practice Address - Street 2:STE. A & B
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1129
Practice Address - Country:US
Practice Address - Phone:239-278-5700
Practice Address - Fax:239-275-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66740174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE71521Medicare UPIN
FLK8831Medicare ID - Type Unspecified