Organization
CHARLOTTE PAIN MANAGEMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY J HARRIS RN (OWNER)
(941) 629-3000
Entity
Organization
Contact information
Practice address
3109 TAMIAMI TRL, UNIT 3, PORT CHARLOTTE, FL 33952-8046
(941) 629-3000
(941) 629-6711
Mailing address
3109 TAMIAMI TRL, UNIT 3, PORT CHARLOTTE, FL 33952-8046
(941) 629-3000
(941) 629-6711
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN1855592
FLORIDA LICENSE
FL
Enumeration date
07/14/2008
Last updated
07/03/2019
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