Fla Pain Management, LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

OS1683 Issued in FL

Legal business name

FLA PAIN MANAGEMENT, LLC

Practice address

279 Douglas Ave
Suite 1108
Altamonte Springs, FL 32714-3324

Phone

(407) 622-7640

Fax

(407) 622-7644

NPI assigned

Jun 9, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Bodo Pyko, D.O.

Title

Physician

Phone

(407) 622-7640

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1053631382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 DOUGLAS AVE",
            "address_2": "SUITE 1108",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143324",
            "telephone_number": "407-622-7640",
            "fax_number": "407-622-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 DOUGLAS AVE",
            "address_2": "SUITE 1108",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143324",
            "telephone_number": "407-622-7640",
            "fax_number": "407-622-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLA PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "PYKO",
        "authorized_official_first_name": "BODO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "407-622-7640",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "OS1683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.