Provider Demographics
NPI:1851358691
Name:SOUTH MIAMI PAIN CENTER INC
Entity Type:Organization
Organization Name:SOUTH MIAMI PAIN CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURCIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-662-2925
Mailing Address - Street 1:6285 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4804
Mailing Address - Country:US
Mailing Address - Phone:305-662-2925
Mailing Address - Fax:305-662-7840
Practice Address - Street 1:6285 SUNSET DR
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4804
Practice Address - Country:US
Practice Address - Phone:305-662-2925
Practice Address - Fax:305-662-7840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265312500Medicaid
FL265312500Medicaid