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Contact Information

ADVANCED PAIN CLINIC PA
505 W VINE ST
SUITE 301
KISSIMMEE, FL34741-4156
 Phone: 407-935-9404
 Fax: 407-935-9304
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Pain

261QP3300X
Indicates primary specialty

NPI Profile & details for ADVANCED PAIN CLINIC PA

NPI # 1861470049
LBN Legal business name ADVANCED PAIN CLINIC PA
Authorized official VRAJLAL RAJYAGURU - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/06/2006
Last updated 07/21/2022 - About 4 years ago
Identifiers
FL License # ME0066759
FL Medicaid 377046000
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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