Unknown Individual – Interventional Pain Medicine Physician, NPI 1659407344
Excluded from federal healthcare programs (Medicare/Medicaid)
This provider is listed on the OIG List of Excluded Individuals/Entities (LEIE). Exclusion effective: 2020-11-19. Reason: License revocation, suspension, or surrender.
Interventional Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
5365 W ATLANTIC AVE STE 504
DELRAY BEACH, FL 334848194
Phone: (561) 241-9300
Fax: (561) 241-9339
Type: Mailing
4219 US HIGHWAY 19
NEW PORT RICHEY, FL 346525906
Phone: (727) 939-2230
Fax: (727) 847-5349
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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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 33484)
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