MEDICARE: INTERVENTIONAL REHABILITATION OF SOUTH FLORIDA, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician
2	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1750805529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERVENTIONAL REHABILITATION OF SOUTH FLORIDA, INC

Provider Business Mailing Address
First Line	:	PO BOX 744069, DEPT 50020
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-4069
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4510 DONALD ROSS RD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-6783
Country	:	US
Telephone Number	:	772-223-2115
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GILBERT DROZDOW
Credential	:	MD
Telephone Number	:	954-838-2371

Provider Enumeration Date	:	08/02/2017
Last Update Date	:	09/24/2019

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