Organization
INTERVENTIONAL PAIN REHAB AND REGENERATIVE CENTER OF FLORIDA
Active
Organization
INTERVENTIONAL PAIN REHAB AND REGENERATIVE CENTER OF FLORIDA
Active
Other names
Anti-Aging, Regeneration and Pain Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE TATAW BESONG M.D (PRESIDENT & CEO)
(386) 747-9771
Entity
Organization
Contact information
Practice address
2275 N VOLUSIA AVE, ORANGE CITY, FL 32763-2833
(386) 774-0109
(386) 774-1203
Mailing address
2111 HONTOON RD, DELAND, FL 32720-4308
(386) 747-9771
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME123086
FL
207V00000X
Obstetrics & Gynecology Physician
ME92729
FL
208VP0000X
Pain Medicine Physician
ME92729
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
ME92729
FL
Other
Enumeration date
02/09/2017
Last updated
01/09/2019
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