MEDICARE: MATRIX PAIN MANAGEMENT

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	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1952151755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATRIX PAIN MANAGEMENT

Provider Business Mailing Address
First Line	:	5602 PGA BLVD STE 101
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3829
Country	:	US
Telephone Number	:	561-246-2422
Fax Number	:	561-627-6444

Provider Business Practice Location Address
First Line	:	5602 PGA BLVD STE 101
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3829
Country	:	US
Telephone Number	:	561-246-2422
Fax Number	:	561-627-6444

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. NATALYNN CINTRON
Credential	:
Telephone Number	:	561-246-2422

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	03/25/2024

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