Organization
INTEGRA NEURO PAIN INSTITUTE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD MASOOM QURESHI MD (PRESIDENT/PHYSICIAN)
(863) 547-0788
Entity
Organization
Contact information
Practice address
5979 VINELAND RD STE 114, ORLANDO, FL 32819-7855
(863) 547-0788
(863) 547-0789
Mailing address
8297 CHAMPIONS GATE BLVD STE 463, CHAMPIONS GATE, FL 33896-8387
(863) 547-0788
(863) 547-0789
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021662900
—
FL
Enumeration date
01/23/2019
Last updated
04/17/2023
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