Organization Active NPI

Central Florida Pain & Spine Institute P a

  • Pain Clinic/Center
  • Ormond Beach, FL
National Provider Identifier
1558573188
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
ME86188 Issued in FL
Legal business name
CENTRAL FLORIDA PAIN & SPINE INSTITUTE P A
Practice address
725 W Granada Blvd
Unit #22
Ormond Beach, FL 32174-5107
Phone
(386) 274-0097
Fax
(386) 274-4996
NPI assigned
May 4, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Rochelle R Cannon
Title
Administrator
Phone
(386) 274-0097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X ME86188 FL Primary

Addresses

Primary practice location

725 W Granada Blvd
Unit #22
Ormond Beach, FL 32174-5107

Mailing address

PO Box 731618
Ormond Beach, FL 32173-1618
Phone (386) 274-0097

Other identifiers 2

IdentifierTypeStateIssuer
ME86188OtherFLFL MEDICAL LIC #
1578507893OtherINDIVIDUAL NPI NUMBER

National Provider Directory

National Provider Directory

Locations

725 W Granada Blvd
Ste 22
Ormond Beach, FL 32174
Phone (386) 274-0097

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1558573188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731618",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321731618",
            "telephone_number": "386-274-0097",
            "fax_number": "386-274-4996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W GRANADA BLVD",
            "address_2": "UNIT #22",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745107",
            "telephone_number": "386-274-0097",
            "fax_number": "386-274-4996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA PAIN & SPINE INSTITUTE P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "ROCHELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-274-0097"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "FL",
            "license": "ME86188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICAL LIC #",
            "identifier": "ME86188",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1578507893",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.