Organization
OUCH, PA
Active
Other names
PHYSICIANS PAIN CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JYOTI PATEL MD (PARTNER)
(904) 808-7246
Entity
Organization
Contact information
Practice address
105 SOUTHPARK BLVD, SUITE C 300, ST AUGUSTINE, FL 32086-4162
(904) 808-7246
(904) 808-7090
Mailing address
105 SOUTHPARK BLVD, SUITE C 300, ST AUGUSTINE, FL 32086-4162
(904) 808-7246
(904) 808-7090
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34189
BLUE CROSS BLUE SHIELD
FL
01
—
7612385
AETNA
FL
Enumeration date
12/18/2006
Last updated
11/17/2011
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