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Contact Information

INSTITUTE FOR HEALTH SPORTS SPINE REHABILITATION & PAIN MANAGE
1895 KINGSLEY AVE STE 1005B
ORANGE PARK, FL32073-4466
 Phone: 904-647-5266
 Fax: 904-770-5594
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for INSTITUTE FOR HEALTH SPORTS SPINE REHABILITATION PAIN MANAGE · (Female)

NPI # 1184171605
Status Active
Credentials
Entity Individual
Enumeration date 09/01/2016
Last updated 08/13/2025 - About 10 months ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # ME117856
  • FL Medicaid 014945000
  • FL Other 1154714129 NPI
  • FL Other 1487954723 NPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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