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Organization
CHARLOTTE PAIN CLINIC INCORPORATED
Active
Organization
CHARLOTTE PAIN CLINIC INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY J HARRIS RN (OWNER)
(941) 629-3000
Entity
Organization
Contact information
Practice address
3109 TAMIAMI TRL, UNIT 3, PORT CHARLOTTE, FL 33952-8046
(941) 629-3000
(941) 629-6711
Mailing address
3109 TAMIAMI TRL, UNIT 3, PORT CHARLOTTE, FL 33952-8046
(941) 629-3000
(941) 629-6711
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
ME16509
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN1855592
FLORIDA LICENSE
FL
Enumeration date
11/08/2007
Last updated
11/14/2007
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