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Organization
FORMOSO PAIN SPECIALISTS, PA
Active
Organization
FORMOSO PAIN SPECIALISTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FERDINAND FORMOSO DO (OWNER)
(904) 588-2393
Entity
Organization
Contact information
Practice address
11555 CENTRAL PKWY STE 304, JACKSONVILLE, FL 32224-2694
(904) 201-3111
(904) 201-3095
Mailing address
11555 CENTRAL PKWY STE 304, JACKSONVILLE, FL 32224-2694
(904) 650-2963
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
06/17/2020
Last updated
04/20/2022
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