Advanced Pain Management Solutions
Organization Active NPI Pain Medicine (Anesthesiology) Physician · Melbourne, FL
NPI 1306601422 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1306601422
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pain Medicine (Anesthesiology) Physician 207LP2900X
- Legal business name
- ADVANCED PAIN MANAGEMENT SOLUTIONS
- Practice address
- 20 E Melbourne Ave Ste 102
Melbourne, FL 32901-5970 - Phone
- (877) 377-6547
- Fax
- (561) 941-4041
- NPI assigned
- Feb 19, 2024
- Organization subpart
- No
Authorized official
- Name
- Regina Luwanda Morris Solis, M.D.
- Title
- Owner
- Phone
- (954) 257-0056
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2302670 | Advanced Pain Management Solutions LLC | Certificate of waiver | Apr 14, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240325000155 | FL | Part B Supplier - Clinic/Group Practice | 5193162303 |
Receives reassigned benefits from 1 practitioner Practice locations: Melbourne, FL |
National Provider Directory
Locations
20 E Melbourne Ave
Ste 102
Melbourne, FL 32901
Phone (877) 377-6547
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician |
207LP2900X | Yes |
Addresses
Primary practice location
20 E Melbourne Ave Ste 102
Melbourne, FL 32901-5970
Mailing address
20 E Melbourne Ave Ste 102
Melbourne, FL 32901-5970
Phone (877) 377-6547
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121454500 | Medicaid | FL |
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All providers in Melbourne, FL · Pain Medicine (Anesthesiology) Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.