CMS-1500 Box 24J / 33a • NPI
1639144017
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
208VP0014X (CMS 09)
Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine
Box 32 Service Location & ZIP+4
111 WATERMAN AVE, MOUNT DORA, FL, 32757-9541
✓ 9-Digit EDI 837 ZIP+4 (32757-9541)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1639144017 (ANESTHESIA AND PAIN CONSULTANTS OF CENTRAL FLORIDA, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1639144017 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ANESTHESIA AND PAIN CONSULTANTS OF CENTRAL FLORIDA, LLC |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine NUCC Code: 208VP0014X (Pain Medicine, Interventional Pain Medicine) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 111 WATERMAN AVE, MOUNT DORA, FL, 32757-9541 |
| Practice Telephone / Fax | Tel: (352) 735-3313 | Fax: (352) 735-3711 |
| Administrative Mailing Address | 111 WATERMAN AVE, MOUNT DORA, FL, 32757-9541 |
| Enumeration & Last Sync | Enumerated: 2006-02-21 | CMS Record Updated: 2025-09-11 |
| Authorized Official | STACY BERCKES (President) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (208VP0014X)
What Does Taxonomy Code 208VP0014X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208VP0014X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ANESTHESIA AND PAIN CONSULTANTS OF CENTRAL FLORIDA, LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207L00000X — AnesthesiologyPlain English: Board-Certified Anesthesiologist & Interventional Pain Specialist | State: N/A | License: Verified | Primary: Secondary |
207LP2900X — Anesthesiology, Pain MedicinePlain English: Board-Certified Anesthesiologist & Interventional Pain Specialist | State: N/A | License: Verified | Primary: Secondary |
208VP0000X — Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Pain Medicine | State: N/A | License: Verified | Primary: Secondary |
208VP0014X — Pain Medicine, Interventional Pain MedicinePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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