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10D2164122 CLIA NUMBER - PAIN MANAGEMENT CONSULTANTS OF SW FLORIDA PL

Laboratory Demographics

CLIA Number: 10D2164122

Facility Name: PAIN MANAGEMENT CONSULTANTS OF SW FLORIDA PL

Facility Address:
9400 BONITA BEACH RD STE #101
BONITA SPRINGS, FL
ZIP 34135
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Facility Phone Number: 239 333-1177

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1649284928

Taxonomy: 207LP2900X - Anesthesiology
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

CLIA Record

Field Name Field Value
CLIA Number 10D2164122
LAB Type Physician Office
Facility Name PAIN MANAGEMENT CONSULTANTS OF SW FLORIDA PL
Street 9400 BONITA BEACH RD STE #101
City BONITA SPRINGS
State FL
ZIP 34135
Phone 239 333-1177
CertificateType 4
CertificateEffectiveDate 3/28/2023
CertificateExpirationDate 3/27/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024