Organization
FORMOSO PAIN SPECIALISTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERDINAND JOSEPH FORMOSO (OWNER)
(904) 588-2393
Entity
Organization
Contact information
Practice address
1361 13TH AVE S STE 170, JACKSONVILLE BEACH, FL 32250-3235
(904) 650-2963
Mailing address
11555 CENTRAL PKWY STE 304, JACKSONVILLE, FL 32224-2694
(904) 650-2963
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
01/06/2022
Last updated
02/15/2022
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