NPIMap

Organization Active NPI

Advanced Pain Clinic PA

  • Pain Medicine (Anesthesiology) Physician
  • Haines City, FL
National Provider Identifier
1972770428
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
ME0066759 Issued in FL
Legal business name
ADVANCED PAIN CLINIC PA
Practice address
82 Maxcy Plaza Cir
Haines City, FL 33844-2488
Phone
(407) 935-9404
NPI assigned
May 14, 2008
Last updated
May 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Dr. Vrajlal L Rajyaguru, MDNPI 1134348014
Title
Medical Director
Phone
(407) 935-9404

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X ME0066759 FL Primary

Addresses

Primary practice location

82 Maxcy Plaza Cir
Haines City, FL 33844-2488

Mailing address

505 W Vine St
301
Kissimmee, FL 34741-4123
Phone (407) 935-9404

Other identifiers 1

IdentifierTypeStateIssuer
377046000MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Advanced Pain Clinic PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1972770428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 W VINE ST",
            "address_2": "301",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414123",
            "telephone_number": "407-935-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 MAXCY PLAZA CIR",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338442488",
            "telephone_number": "407-935-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PAIN CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "RAJYAGURU",
        "authorized_official_first_name": "VRAJLAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "407-935-9404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME0066759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377046000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.