NPIMap

Organization Active NPI

Certified Spine and Pain Care LLC

  • Interventional Pain Medicine Physician
  • Wellington, FL
National Provider Identifier
1124561733
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME92323 Issued in FL
Legal business name
CERTIFIED SPINE AND PAIN CARE LLC
Practice address
1049 S State Rd
Wellington, FL 33414-6135
Phone
(561) 578-4582
Fax
(561) 432-4843
NPI assigned
Nov 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Authorized official

Name
Jorge Garcia
Title
Credentialing Director
Phone
(561) 537-4526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X ME92323 FL Primary

Addresses

Primary practice location

1049 S State Rd
Wellington, FL 33414-6135

Mailing address

1049 S State Road 7
Wellington, FL 33414-6135
Phone (561) 537-4526

National Provider Directory

National Provider Directory
Tax ID family
Certified Spine and Pain Care LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1124561733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 S STATE ROAD 7",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146135",
            "telephone_number": "561-537-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 S STATE RD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146135",
            "telephone_number": "561-578-4582",
            "fax_number": "561-432-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERTIFIED SPINE AND PAIN CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-30",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "561-537-4526"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME92323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.