Organization Active NPI

Pain Treatment Specialists

  • Interventional Pain Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1215429717
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME132254 Issued in FL
Legal business name
PAIN TREATMENT SPECIALISTS
Practice address
2601 E Oakland Park Blvd Ste 200
Fort Lauderdale, FL 33306
Phone
(617) 314-0603
NPI assigned
May 31, 2018
Last updated
Jun 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Authorized official

Name
Youmna Distefano, MDNPI 1851687750
Title
Managing Director
Phone
(617) 314-0603

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME132254 FL
Pain Medicine Physician 208VP0000X ME132254 FL
Interventional Pain Medicine Physician 208VP0014X ME132254 FL Primary

Addresses

Primary practice location

2601 E Oakland Park Blvd Ste 200
Fort Lauderdale, FL 33306

Mailing address

2601 E Oakland Park Blvd Ste 200
Fort Lauderdale, FL 33306-1612
Phone (954) 500-7246

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2155642Pain Treatment Specialists2601 E Oakland Park Blvd Ste 200, Fort Lauderdale, FL 33306Certificate of waiverOct 1, 2026

National Provider Directory

National Provider Directory

Locations

2601 E Oakland Park Blvd
Ste 200
Fort Lauderdale, FL 33306
Phone (617) 314-0603

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1215429717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E OAKLAND PARK BLVD STE 200",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061612",
            "telephone_number": "954-500-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E OAKLAND PARK BLVD STE 200",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33306",
            "telephone_number": "617-314-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN TREATMENT SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "DISTEFANO",
        "authorized_official_first_name": "YOUMNA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "617-314-0603",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME132254",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME132254",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME132254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.