Southern Interventional Pain Center LLC
Southern Interventional Pain Center LLC is a Neurology Physician in Lake City, Florida. Registered with an NPI since 2019.
- In the registry since
- 2019
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
619 SW Baya Dr Ste 102Lake City, FL 32025-4204
Phone: (386) 361-3400
Fax: (855) 313-1262
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Interventional Pain Medicine Physician (primary) | Taxonomy 208VP0014X |
|---|---|
| Neurology Physician | Taxonomy 2084N0400X |
Record details
| NPI number | 1063971596 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Southern Interventional Pain Center LLC |
| Authorized official | Maximilian Shokat — Managing Member · (229) 226-2234 |
| NPI enumerated | March 14, 2019 |
| Last updated in NPPES | January 31, 2020 |
| Certification date | January 31, 2020 |
| Mailing address | 615 S Hansell St, Thomasville, GA 31792-5556 |
Other providers in Lake City
-
North Florida Neurodiagnostics, LLC
426 SW Commerce Dr Ste 101, Lake City, FL 32025-1506 · (386) 288-5311