Organization
PREMIER PAIN SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULES ALVA PREUDHOMME M.D (PRESIDENT)
(239) 945-1105
Entity
Organization
Contact information
Practice address
1228 SE 8TH TER, CAPE CORAL, FL 33990-3210
(239) 945-1105
(239) 945-4495
Mailing address
1228 SE 8TH TER, CAPE CORAL, FL 33990-3210
(239) 945-1105
(239) 945-4495
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME72077
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0403035
WORKERS COMPENSATON
FL
01
—
050085760
MEDICARE RAILROAD
FL
01
—
1132487
FIRST HEALTH
FL
01
—
285839
BC/BS VIRTUAL
FL
01
—
352107800
ACS
FL
01
—
43550
BLUE CROSS BLUE SHIELD OF
FL
01
—
7040371
AETNA
FL
01
—
P2816206
OXFORD
FL
Enumeration date
11/01/2006
Last updated
12/02/2021
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