FORMOSO PAIN SPECIALISTS, PA (NPI# 1487270351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487270351 |
| Entity Type | Organization |
| Organization Name | FORMOSO PAIN SPECIALISTS, PA |
| Practice Address |
11555 Central Pkwy Ste 304 Jacksonville FL 32224-2694 |
| Mailing Address |
4472 Glen Kernan Pkwy E Jacksonville FL 32224-5626 |
| Practice Telephone | 9042654333 |
| Mailing Telephone | 9045882393 |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-06-17 |
| Authorized Official Name | DR. FERDINAND FORMOSO (OWNER) |
| Authorized Official Telephone | 9045882393 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11555 Central Pkwy Ste 303, Jacksonville, FL 322242694 | 9042654333 |
| Street Address |
11555 CENTRAL PKWY STE 304 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-2694 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912979584 | Jeffrey Michael Green | Physician Assistant | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2006-02-07 |
| 1881089613 | Physicians Group Services | Family Medicine | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2015-03-30 |
| 1396007993 | Andrew David Green | Nurse Practitioner | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2012-06-11 |
| 1346554771 | Physicians Group Services Pa | Family Medicine | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2010-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| Find all providers in zip 32224 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497006423 | Jacksonville Pain and Injury Center, Inc | Pain Medicine | 4051 Phillips Hwy Ste 2, Jacksonville, FL 32207-6895 | 2012-10-01 |
| 1184945917 | Axiom Pain Management LLC | Pain Medicine | 2160 Dunn Ave, Jacksonville, FL 32218-4718 | 2010-06-16 |
| 1457587891 | Perry Jc Md Pa | Pain Medicine | 7999 Philips Hwy, Ste 302, Jacksonville, FL 32256-4443 | 2009-05-29 |
| 1255351110 | Scott Richard Johnston | Pain Medicine | 250 Huff Dr, Jacksonville, NC 28546-7369 | 2006-07-20 |
| 1194722512 | Craig Allen Kornick | Pain Medicine | 7207 Golden Wings Road, Jacksonville, FL 32244 | 2005-06-30 |
| 1154326973 | Hemant N Shah | Pain Medicine | 9421 Waypoint Pl, Jacksonville, FL 32257-9229 | 2005-06-17 |
| 1104460096 | Spencer Rice | Pain Medicine | 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 | 2019-11-04 |
| 1831744549 | Orles Pain Management and Regenerative Medicine Group Pa | Pain Medicine | 4131 University Blvd S Ste 12, Jacksonville, FL 32216-4352 | 2019-08-08 |
| 1760976260 | Jacksonville Spine Center Pa | Pain Medicine | 15255 Max Leggett Pkwy Ste 5500, Jacksonville, FL 32218-7273 | 2018-06-18 |
| 1356840409 | Advanced Pain Management Group, Inc. | Pain Medicine | 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 | 2018-02-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
Please comment or provide details below to improve the information on FORMOSO PAIN SPECIALISTS, PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.