Organization
PAIN RELIEF AND PHYSICAL REHAB INC
Active
Organization
PAIN RELIEF AND PHYSICAL REHAB INC
Active
Other names
Pain Relief and Physical Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH S SUSKO M.D. (PRESIDENT)
(239) 226-0077
Entity
Organization
Contact information
Practice address
4977 ROYAL GULF CIR, FORT MYERS, FL 33966-7006
(239) 226-0077
(239) 489-0077
Mailing address
9705 COMMERCE CENTER CT STE 103, FORT MYERS, FL 33908-3767
(239) 437-9313
(239) 245-8060
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17033
BCBS
FL
01
—
17033X
MEDICARE
FL
05
—
2658666-00
—
FL
Enumeration date
09/17/2008
Last updated
09/26/2023
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