PALM TREE INTERVENTIONAL PAIN MANAGEMENT PLLC NPI 1336682764

NPI Information

  • NPI: 1336682764
  • Provider Name: PALM TREE INTERVENTIONAL PAIN MANAGEMENT, PLLC
  • Classification: Physical Medicine & Rehabilitation - 2081P2900X
  • Specialization: Pain Medicine
  • Entity Type: Organization
  • Address: 2801 17TH ST UNIT 202
    SAINT CLOUD, FL
    ZIP 34769
  • Phone: (407) 906-1328

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NPI Details

PALM TREE INTERVENTIONAL PAIN MANAGEMENT, PLLC is a pain medicine physical medicine rehabilitation in Saint Cloud, 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. PALM TREE INTERVENTIONAL PAIN MANAGEMENT, PLLC NPI is 1336682764. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2801 17TH ST UNIT 202
SAINT CLOUD, FL
ZIP 34769-939
Phone: (407) 906-1328
Fax: (866) 425-8143

The provider's authorized official is Jason Jeong Hwan Song .
The authorized official title is Medical Director and has the following contact phone number (267) 312-9857.

The enumeration date for this NPI number is 12/3/2016 and was last updated on 10/1/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208100000XPhysical Medicine & RehabilitationFLORIDANo
2208VP0014XPain MedicineInterventional Pain MedicineFLORIDANo
32081P2900XPhysical Medicine & RehabilitationPain MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1020119900MEDICAIDFLORIDA

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: 11/21/2025

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