Healthcare Provider Details

I. General information

NPI: 1639483969
Provider Name (Legal Business Name): DANE C POHLMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 05/25/2023
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8130 ROYAL PALM BLVD STE 104
CORAL SPRINGS FL
33065-5703
US

IV. Provider business mailing address

1753 NE 9TH ST
FORT LAUDERDALE FL
33304-4442
US

V. Phone/Fax

Practice location:
  • Phone: 754-206-1877
  • Fax: 754-229-3866
Mailing address:
  • Phone: 314-283-8738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberQ3271
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS14281
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: