Organization
INTERVENTIONAL SPINE AND PAIN INSTITUTE LLC
Active
Organization
INTERVENTIONAL SPINE AND PAIN INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHAEDRA L SHUDRA (CREDENTIALING AND CONTRACTING SPECI)
(813) 785-4861
Entity
Organization
Contact information
Practice address
5200 BABCOCK ST NE STE 111, PALM BAY, FL 32905-4639
(772) 360-1997
(772) 492-3541
Mailing address
777 37TH ST STE C101, VERO BEACH, FL 32960-7301
(772) 360-1997
(772) 492-3541
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
09/26/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up