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FORMOSO PAIN SPECIALISTS PA NPI 1487270351


NPI Information

NPI: 1487270351
Provider Name: FORMOSO PAIN SPECIALISTS, PA
Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 10D2252773

Address:
11555 CENTRAL PKWY STE 304
JACKSONVILLE, FL
ZIP 32224
Phone: (904) 201-3111
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FORMOSO PAIN SPECIALISTS, PA is a pain medicine physical medicine rehabilitation in Jacksonville, FL. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. FORMOSO PAIN SPECIALISTS, PA NPI is 1487270351. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

11555 CENTRAL PKWY STE 304
JACKSONVILLE, FL
ZIP 32224-694
Phone: (904) 201-3111
Fax: (904) 201-3095

The provider's authorized official is Ferdinand Formoso .
The authorized official title is Owner and has the following contact phone number (904) 588-2393.

The CLIA number assigned to this NPI record is 10D2252773 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/17/2020 and was last updated on 4/20/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208VP0014XPain MedicineInterventional Pain MedicineNo
22081P2900XPhysical Medicine & RehabilitationPain MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.