PAIN SPINE & WELLNESS LLC NPI 1942868377

NPI Information

  • NPI: 1942868377
  • Provider Name: PAIN SPINE & WELLNESS LLC
  • Classification: Family Medicine - 207QA0505X
  • Specialization: Adult Medicine
  • Entity Type: Organization
  • Doing Business As: DEDICATED PAIN & WELLNESS
  • CLIA Number: 10D2210223
  • Address: 9770 OLD BAYMEADOWS RD STE 141
    JACKSONVILLE, FL
    ZIP 32256
  • Phone: (904) 944-2124

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NPI Details

PAIN SPINE & WELLNESS LLC is an adult medicine family medicine in Jacksonville, FL. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. PAIN SPINE & WELLNESS LLC NPI is 1942868377. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Dedicated Pain & Wellness.

The provider's business location address is:

9770 OLD BAYMEADOWS RD STE 141
JACKSONVILLE, FL
ZIP 32256-986
Phone: (904) 944-2124
Fax: (888) 241-3383

The provider's authorized official is Sourial Morris Sourial .
The authorized official title is President and has the following contact phone number (904) 944-2124.

The CLIA number assigned to this NPI record is 10D2210223 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2019 and was last updated on 11/11/2024.

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
1207QA0505XFamily MedicineAdult MedicineYes
2208VP0000XPain MedicinePain MedicineNo
3261QM1300XClinic/CenterMulti-SpecialtyNo

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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