Provider Demographics
NPI:1023763570
Name:ADVANCED INTEGRATED PAIN & SPINE SOLUTIONS
Entity type:Organization
Organization Name:ADVANCED INTEGRATED PAIN & SPINE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NARENDREN
Authorized Official - Middle Name:
Authorized Official - Last Name:NARAYANASAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-807-0098
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34755-0607
Mailing Address - Country:US
Mailing Address - Phone:407-807-0098
Mailing Address - Fax:407-530-0864
Practice Address - Street 1:1925 DON WICKHAM DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1915
Practice Address - Country:US
Practice Address - Phone:407-807-0098
Practice Address - Fax:407-530-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty