Organization
AFA PAIN SPECIALISTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARIQ LATIF (PRESIDENT)
(904) 654-3918
Entity
Organization
Contact information
Practice address
728 BLANDING BLVD, SUITE C, ORANGE PARK, FL 32065-7728
(904) 639-6747
(904) 639-6769
Mailing address
PO BOX 65748, ORANGE PARK, FL 32065-0013
(904) 639-6747
(904) 639-6769
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME113190
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
ME113190
FL
Other
Enumeration date
02/13/2015
Last updated
12/02/2015
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