EXCEL PAIN AND SPINE LLC – Pain Medicine (Physical Medicine & Rehabilitation) Physician, NPI 1063028587
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for EXCEL PAIN AND SPINE LLC
771 CYPRESS VILLAGE BLVD
SUN CITY CENTER, FL 335736801
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
PO BOX 25201
TAMPA, FL 336225201
Phone: (813) 701-5804
Fax: (813) 536-3413
Type: Mailing
1749 6th St NW
Winter Haven, FL 338812301
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
2202 Duck Slough Blvd Ste 102
New Port Richey, FL 346555071
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
7032 US Highway 301 N
Ellenton, FL 342223030
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
1417 Lakeland Hills Blvd Ste 201
Lakeland, FL 338053208
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
2310 North Blvd W Ste A
Davenport, FL 338378988
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
620 S Macdill Ave Ste B
Tampa, FL 336094691
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
414 W Robertson St
Brandon, FL 335115007
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
3909 GALEN CT STE 104
SUN CITY CENTER, FL 335736824
Phone: (813) 701-5804
Fax: (813) 536-3413
Type: Location
400 Avenue K SE Ste 9
Winter Haven, FL 338804123
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
326 S 6th Ave
Wauchula, FL 338733207
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
26851 Tanic Dr Ste 102
Wesley Chapel, FL 335444614
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
3333 Clark Rd Ste 190
Sarasota, FL 342318435
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
2100 1st Ave S Ste 100B
St Petersburg, FL 337121212
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
28050 US Highway 19 N Ste 100
Clearwater, FL 337612600
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
3218 W Azeele St
Tampa, FL 336093018
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
1611 Harden Blvd
Lakeland, FL 338031826
Phone: (813) 701-5804
Fax: (813) 291-7615
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-02-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-05-31 (737 days ago).
Enrollment records
2
Earliest due date
2024-05-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20200930001765 | O | Clinic/Group Practice | FL | 2026-07-31 |
| O20210203002303 | O | Physician - Physical And Rehabilitation | FL | 2024-05-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33573)
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