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FORMOSO PAIN SPECIALISTS, PA
NPI 1548105372
Clinic/Center - Pain in Jacksonville, FL

Active since April 20, 2026CLIA 10D2343468 · Waiver
857 EDGEWOOD AVE S, JACKSONVILLE, FL 32205(904) 201-3111(904) 201-3095 Get Directions Write a Review

NPPES record last updated: April 20, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Formoso Pain Specialists, Pa NPPES

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

FORMOSO PAIN SPECIALISTS, PA (NPI 1548105372) is a healthcare organization registered as a pain in Jacksonville, Florida and active in the NPI registry since April 2026. The organization holds a CLIA Waiver certificate valid through May 6, 2028 and lists Ferdinand Joseph Formoso, Owner/ceo, as its authorized official.

NPPES Registry Identity

NPI1548105372
Entity TypeOrganization
Primary Taxonomy261QP3300X
Legal Business NameFORMOSO PAIN SPECIALISTS, PA
Location Address857 EDGEWOOD AVE SJacksonville, FL 32205-5362
Mailing Address857 Edgewood Ave SJacksonville, FL 32205-5362 · (904) 201-3111 · Fax (904) 201-3095
Phone(904) 201-3111
Fax(904) 201-3095
Organization SubpartNo
Authorized OfficialFerdinand Joseph FormosoOwner/ceo · (904) 201-3111
Enumeration DateApril 20, 2026
NPPES CertifiedApril 20, 2026
✔ NPI 1548105372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · PainAmbulatory Health Care Facilities
Taxonomy Code261QP3300X
Also ListedPhysical Medicine & Rehabilitation · Pain MedicineTaxonomy 2081P2900X
857 EDGEWOOD AVE S, Jacksonville, FL 32205
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Waiver 10D2343468

Formoso Pain Specialists, PA · Jacksonville, FL
Active · expires May 6, 2028
CLIA Number10D2343468
Laboratory TypePhysician Office
Certificate Effective DateMay 7, 2026
Certificate Expiration DateMay 6, 2028
Laboratory DirectorFerdinand J. Formoso
Laboratory Phone(904) 456-1910
Laboratory LocationFormoso Pain Specialists, PA857 Edgewood Ave South, Jacksonville, FL 32205
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Formoso Pain Specialists, PA's NPI number?

The NPI number for Formoso Pain Specialists, PA is 1548105372. It was assigned to this organization in the NPPES registry on April 20, 2026.

Where is Formoso Pain Specialists, PA located?

Formoso Pain Specialists, PA is located at 857 Edgewood Ave S, Jacksonville, FL 32205. The listed phone number is (904) 201-3111.

What is Formoso Pain Specialists, PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Pain, with taxonomy code 261QP3300X.

Does Formoso Pain Specialists, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2343468) is associated with this NPI, valid through May 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Formoso Pain Specialists, PA was last updated on April 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.