Organization
CENTER FOR PAIN TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAXI MERCADO (ADMINISTRATOR)
(321) 615-0784
Entity
Organization
Contact information
Practice address
989 SEBASTIAN BLVD UNIT 3, SEBASTIAN, FL 32958-4879
(727) 617-1777
(888) 836-2203
Mailing address
989 SEBASTIAN BLVD UNIT 3, SEBASTIAN, FL 32958-4879
(727) 617-1777
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OL553
HF MEDICARE
FL
Enumeration date
03/22/2019
Last updated
01/18/2022
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