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

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

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

Locations

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.