Provider Demographics
NPI:1902486939
Name:FLORIDA PAIN AND REHABILITATION ASSOCIATES INC
Entity Type:Organization
Organization Name:FLORIDA PAIN AND REHABILITATION ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-841-7135
Mailing Address - Street 1:11350 MCCORMICK RD.
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031
Mailing Address - Country:US
Mailing Address - Phone:678-841-7123
Mailing Address - Fax:678-841-7223
Practice Address - Street 1:978 INTERNATIONAL PKWY STE 1440
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-5233
Practice Address - Country:US
Practice Address - Phone:407-624-5028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty