Active NPI
Last Resort Pain Treatment Center LLC
- Pain Medicine (Anesthesiology) Physician
- Lakeland, FL
National Provider Identifier
1932235280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- ME79018
- Legal business name
- LAST RESORT PAIN TREATMENT CENTER LLC
- Practice address
- 4406 S Florida Ave
Ste 16
Lakeland, FL 33813-2172 - Phone
- (863) 709-8000
- Fax
- (863) 709-8002
- NPI assigned
- Feb 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. W Lance McKitrick, M.D., D.D.S.
- Title
- Owner
- Phone
- (863) 709-8002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | ME79018 | FL | Primary |
Addresses
Primary practice location
4406 S Florida Ave
Ste 16
Lakeland, FL 33813-2172
Mailing address
4406 S Florida Ave
Ste 16
Lakeland, FL 33813-2172
Phone (863) 709-8000
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1932235280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4406 S FLORIDA AVE",
"address_2": "STE 16",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338132172",
"telephone_number": "863-709-8000",
"fax_number": "863-709-8002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4406 S FLORIDA AVE",
"address_2": "STE 16",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338132172",
"telephone_number": "863-709-8000",
"fax_number": "863-709-8002"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAST RESORT PAIN TREATMENT CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MCKITRICK",
"authorized_official_first_name": "W",
"authorized_official_middle_name": "LANCE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "863-709-8002",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D., D.D.S."
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology, Pain Medicine",
"state": "FL",
"license": "ME79018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.