Advanced Integrated Pain & Spine Solutions

Organization Active NPI Pain Medicine Physician · Clermont, FL

NPI 1023763570 · NPPES record last updated Mar 1, 2022

Key facts

NPI
1023763570
Entity type
Organization (NPI type 2)
Primary specialty
Pain Medicine Physician 208VP0000X
Legal business name
ADVANCED INTEGRATED PAIN & SPINE SOLUTIONS
Practice address
1925 Don Wickham Dr
Clermont, FL 34711-1915
Phone
(407) 807-0098
Fax
(407) 530-0864
NPI assigned
Feb 14, 2022
Organization subpart
No

Authorized official

Name
Narendren Narayanasamy, MD
Title
Owner
Phone
(407) 807-0098

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220520000149 FL Part B Supplier - Clinic/Group Practice 0244617819 Receives reassigned benefits from 1 practitioner
Practice locations: Clermont, FL; Four Corners, FL; Lady Lake, FL

National Provider Directory

Locations

865 Oakley Seaver Dr
Clermont, FL 34711
Phone (352) 432-3939

17075 Cagan Ridge Blvd
Ste 101
Clermont, FL 34714
Phone (352) 717-4377

108 Park Place Blvd
Ste B
Davenport, FL 33837
Phone (863) 438-5895

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208VP0000X Yes

Addresses

Primary practice location

1925 Don Wickham Dr
Clermont, FL 34711-1915

Mailing address

PO Box 607
Minneola, FL 34755-0607
Phone (407) 807-0098

Other providers in Clermont, FL

All providers in Clermont, FL · Pain Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.