Organization
PAIN MANAGEMENT CONSULTANTS OF SOUTHWEST FLORIDA, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE D MAHANEY MD (MANAGER)
(239) 333-1177
Entity
Organization
Contact information
Practice address
7964 SUMMERLIN LAKES DR, FORT MYERS, FL 33907-1816
(239) 333-1177
(239) 333-1169
Mailing address
PO BOX 7440, FORT MYERS, FL 33911-7440
(239) 333-1177
(239) 939-4733
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273924100
—
FL
01
—
611443800
DOL WORKERS COMPENSATION
—
01
—
94990
BC BS FLORIDA GROUP PROV
FL
01
—
DD8974
RAILROAD MEDICARE PROV #
FL
Enumeration date
07/29/2006
Last updated
04/25/2019
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