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Organization
FLORIDA PAIN MANAGEMENT CENTER, INC
Active
Organization
FLORIDA PAIN MANAGEMENT CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY J. BERCKES M.D. (PRESIDENT)
(352) 735-3313
Entity
Organization
Contact information
Practice address
111 WATERMAN AVE, MOUNT DORA, FL 32757-9541
(352) 735-3313
(352) 735-3711
Mailing address
111 WATERMAN AVE, MOUNT DORA, FL 32757-9541
(352) 735-3313
(352) 735-3711
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
01/26/2006
Last updated
12/13/2013
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