Provider Demographics
NPI:1871792135
Name:BANIONIS, SAULIS M (MD)
Entity type:Individual
Prefix:DR
First Name:SAULIS
Middle Name:M
Last Name:BANIONIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1447 MEDICAL PARK BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3164
Mailing Address - Country:US
Mailing Address - Phone:561-537-4817
Mailing Address - Fax:561-795-9594
Practice Address - Street 1:1447 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3164
Practice Address - Country:US
Practice Address - Phone:561-537-4817
Practice Address - Fax:561-795-9594
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2013-11-12
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Provider Licenses
StateLicense IDTaxonomies
FLME98566174400000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6722500001Medicare NSC