Organization
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC
Active
Parent organization
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC
Authorized official
MR. SWAMY YATHAM (DIRECTOR)
(407) 622-7246
Entity
Organization
Contact information
Practice address
1530 CITRUS MEDICAL CT, SUITE 101, OCOEE, FL 34761-4548
(407) 622-7246
(407) 599-7246
Mailing address
1170 S SEMORAN BLVD, ORLANDO, FL 32807-1458
(407) 622-7246
(407) 599-7246
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
06/05/2013
Last updated
11/26/2014
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