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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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