Organization
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SWAMY YATHAM (DIRECTOR)
(407) 622-7246
Entity
Organization
Contact information
Practice address
451 S MILWEE ST, LONGWOOD, FL 32750-4140
(407) 622-7246
(407) 599-7246
Mailing address
1170 S SEMORAN BLVD, ORLANDO, FL 32807
(407) 622-7246
(407) 599-7246
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
04/29/2011
Last updated
11/26/2014
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