Pain Care Management of Melbourne, LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

PMC1568 Issued in FL

Legal business name

PAIN CARE MANAGEMENT OF MELBOURNE, LLC

Doing business as

Atlantis Pain Care

Practice address

3150 N Wickham Rd
Suite 9
Melbourne, FL 32935-2322

Phone

(321) 773-4134

Fax

(321) 574-5611

NPI assigned

Oct 7, 2010

Last updated

Feb 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. C R Long

Title

Managing Member

Phone

(321) 251-4462

Specialties & licenses 1

Addresses

Other names 1

• Atlantis Pain Care Doing business as

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1578872602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 DR PHILLIPS BLVD",
            "address_2": "SUITE 337",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328193310",
            "telephone_number": "321-251-4462",
            "fax_number": "888-469-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N WICKHAM RD",
            "address_2": "SUITE 9",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352322",
            "telephone_number": "321-773-4134",
            "fax_number": "321-574-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE MANAGEMENT OF MELBOURNE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-07",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "321-251-4462",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "FL",
            "license": "PMC1568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantis Pain Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Paffenroth
• Jennifer Pagan Pallens, M.D.
• Heather Page, PMHNP
• Willie Pahl Jr.
• Robert M Paige, MD
• Jonathan T. Paine, M.D.
• Karin Painter
• Mary Paisley, LMHC
• Christin Pajuelo, APRN
• Julieta Pajuelo, APRN

• Pain Clinic/Center in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Pain Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.