NPIMap

Organization Active NPI

Pain and Spine Centers of Florida LLC

  • Pain Medicine Physician
  • Tavares, FL
National Provider Identifier
1942587902
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
PAIN AND SPINE CENTERS OF FLORIDA LLC
Practice address
2146 Vindale Rd
Tavares, FL 32778-5602
Phone
(352) 343-7246
Fax
(352) 259-8959
NPI assigned
Nov 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Authorized official

Name
Sridhar Pinnamaneni, MDNPI 1972770204
Title
Medical Doctor
Phone
(352) 343-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

2146 Vindale Rd
Tavares, FL 32778-5602

Mailing address

2146 Vindale Rd
Tavares, FL 32778-5602
Phone (352) 343-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111215000653 FL Part B Supplier - Clinic/Group Practice 2769657972 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
Practice locations: Leesburg, FL; Lady Lake, FL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1942587902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2146 VINDALE RD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785602",
            "telephone_number": "352-343-7246",
            "fax_number": "352-259-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2146 VINDALE RD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785602",
            "telephone_number": "352-343-7246",
            "fax_number": "352-259-8959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN AND SPINE CENTERS OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "PINNAMANENI",
        "authorized_official_first_name": "SRIDHAR",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "352-343-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.