NPIMap

Organization Active NPI

Advanced Pain Management Specialist

  • Non-Pharmacy Dispensing Site
  • Fort Myers, FL
National Provider Identifier
1104005859
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
BD1688641 Issued in FL
Legal business name
ADVANCED PAIN MANAGEMENT SPECIALIST
Practice address
6120 Winkler Rd
Suite J
Fort Myers, FL 33919-8125
Phone
(239) 437-8000
NPI assigned
Oct 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Authorized official

Name
Dr. Jonathan S Daitch
Title
Physician
Phone
(239) 437-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X BD1688641 FL Primary

Addresses

Primary practice location

6120 Winkler Rd
Suite J
Fort Myers, FL 33919-8125

Mailing address

PO Box 07400
Fort Myers, FL 33919-0400
Phone (239) 437-8000

National Provider Directory

National Provider Directory
Tax ID family
Advanced Pain Management and Spine Specialists3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1104005859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 07400",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339190400",
            "telephone_number": "239-437-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 WINKLER RD",
            "address_2": "SUITE J",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198125",
            "telephone_number": "239-437-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PAIN MANAGEMENT SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "DAITCH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "239-437-8000",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "BD1688641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.