Organization
PCA INTERVENTIONAL SPINE AT FAYETTE, LLC
Active
Organization
PCA INTERVENTIONAL SPINE AT FAYETTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODRIGO DURALDE MD (OWNER)
(404) 351-7654
Entity
Organization
Contact information
Practice address
1233 HIGHWAY 54 W, SUITE 205, FAYETTEVILLE, GA 30214-4542
(404) 351-7654
Mailing address
PO BOX 40061, BELFAST, ME 04915-1237
(678) 971-4167
(833) 989-2501
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
IN PROCESS
GA
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
03/15/2017
Last updated
02/20/2026
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