Provider Demographics
NPI:1013242262
Name:STOP THE PAIN CSP
Entity Type:Organization
Organization Name:STOP THE PAIN CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOPEZ-BRACETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-525-0731
Mailing Address - Street 1:35 CALLE JUAN C BORBON
Mailing Address - Street 2:STE 67-465
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5374
Mailing Address - Country:US
Mailing Address - Phone:787-525-0731
Mailing Address - Fax:787-848-0318
Practice Address - Street 1:311 AVE DOMENECH
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3511
Practice Address - Country:US
Practice Address - Phone:787-525-0731
Practice Address - Fax:787-848-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16661208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty