Organization Active NPI

Last Resort Pain Treatment Center LLC

  • Pain Medicine (Anesthesiology) Physician
  • Lakeland, FL
National Provider Identifier
1932235280
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
ME79018 Issued in FL
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.