| Compassionate Health And Managed Pain Llc | |
|
570 Memorial Cir Suite 200 Ormond Beach FL 32174-5002 | |
| (386) 451-2346 | |
| Not Available |
| Full Name | Compassionate Health And Managed Pain Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 570 Memorial Cir, Ormond Beach, Florida |
| Authorized Official Name and Position | Tish J Brown (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 3869449813 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compassionate Health And Managed Pain Llc 570 Memorial Cir Suite 200 Ormond Beach FL 32174-5002 Ph: (386) 451-2346 | Compassionate Health And Managed Pain Llc 570 Memorial Cir Suite 200 Ormond Beach FL 32174-5002 Ph: (386) 451-2346 |
| NPI Number | 1184165862 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 01/31/2024 |
| Certification Date | 01/31/2024 |
| Medicare PECOS PAC ID | 2668749490 |
|---|---|
| Medicare Enrollment ID | O20170530000959 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184165862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | ME101968 (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | ME101968 (Florida) | Primary |
| Provider Name | Jorge Luis Anibal Mirabelli |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164455119 PECOS PAC ID: 2860460573 Enrollment ID: I20170530001044 |
| Provider Name | Teresa Jean Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962159582 PECOS PAC ID: 6103195433 Enrollment ID: I20231025002566 |
| Provider Name | Ruby Perakis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649922949 PECOS PAC ID: 8527415306 Enrollment ID: I20231116000677 |
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