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ADVANCED PAIN MANAGEMENT SPECIALIST
NPI 1104005859
Non-Pharmacy Dispensing Site in Fort Myers, FL

Active since October 30, 2007CLIA 10D1016906 · Accreditation
6120 WINKLER RD, SUITE J, FORT MYERS, FL 33919(239) 437-8000 Get Directions Write a Review

NPPES record last updated: December 3, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Advanced Pain Management Specialist NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVANCED PAIN MANAGEMENT SPECIALIST (NPI 1104005859) is a healthcare organization registered as a non-pharmacy dispensing site in Fort Myers, Florida and active in the NPI registry since October 2007. The organization holds an CLIA Accreditation certificate valid through February 26, 2027 and lists Jonathan S Daitch, Physician, as its authorized official.

NPPES Registry Identity

NPI1104005859
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameADVANCED PAIN MANAGEMENT SPECIALIST
Location Address6120 WINKLER RD, SUITE JFort Myers, FL 33919-8125
Mailing AddressPo Box 07400Fort Myers, FL 33919-0400 · (239) 437-8000
Phone(239) 437-8000
Organization SubpartNo
Authorized OfficialJonathan S DaitchPhysician · (239) 437-8000
Enumeration DateOctober 30, 2007
Last NPPES UpdateDecember 3, 2008
✔ NPI 1104005859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in FL · BD1688641
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
6120 WINKLER RD, Fort Myers, FL 33919
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 10D1016906

Advanced Pain Management Specialists PA D/B/A Advanced Pain Management & Spine Specialists · Fort Myers, FL
Active · expires Feb 26, 2027
CLIA Number10D1016906
Laboratory TypePhysician Office
Certificate Effective DateFebruary 27, 2025
Certificate Expiration DateFebruary 26, 2027
Laboratory DirectorDr. Nadya Wood Harry
Laboratory Phone(239) 437-8000
Laboratory LocationAdvanced Pain Management Specialists PA D/B/A Advanced Pain Management & Spine Specialists8255 College Pkwy Ste 200, Fort Myers, FL 33919
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRIMARY CARE SPECIALISTS OF
Family Medicine
6120 WINKLER RD, SUITE H
FORT MYERS, FL 33919
Lee County (239) 337-9422
COSSU AND LUKASIEWICZ P A
General Practice
6120 WINKLER RD, STE E
FORT MYERS, FL 33919
Lee County (239) 481-2400
DR. DAVID ISAAC GREENBERG DMD
Dentist
6120 WINKLER RD, SUITE I
FORT MYERS, FL 33919
Lee County (239) 481-6433
DR. RANDOLPH MACON RICHARDSON IV DMD MD
Oral & Maxillofacial Surgery
6120 WINKLER RD, STE F
FORT MYERS, FL 33919
Lee County (239) 437-1500
ADVANCED LABS OF SW FLORIDA, LLC
Clinical Medical Laboratory
6120 WINKLER RD, SUITE J
FORT MYERS, FL 33919
Lee County (239) 789-4130

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Advanced Pain Management Specialist's NPI number?

The NPI number for Advanced Pain Management Specialist is 1104005859. It was assigned to this organization in the NPPES registry on October 30, 2007.

Where is Advanced Pain Management Specialist located?

Advanced Pain Management Specialist is located at 6120 Winkler Rd Suite J, Fort Myers, FL 33919. The listed phone number is (239) 437-8000.

What is Advanced Pain Management Specialist's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Advanced Pain Management Specialist hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 10D1016906) is associated with this NPI, valid through February 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Advanced Pain Management Specialist was last updated on December 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.