Organization
PAN AMERICAN PAIN INSTITUTE PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARIO AQUILES GRISALES MD (OWNER PROVIDER)
(813) 908-7868
Entity
Organization
Contact information
Practice address
16542 N DALE MABRY HWY, TAMPA, FL 33618-1325
(813) 908-7868
Mailing address
PO BOX 20286, TAMPA, FL 33622-0286
(727) 823-2188
(727) 823-9502
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
ME79046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD7254
RAILROAD MEDICARE
—
Enumeration date
11/01/2006
Last updated
02/11/2010
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