Healthcare Provider Details

I. General information

NPI: 1841813920
Provider Name (Legal Business Name): SOUTH FLORIDA PAIN CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 05/22/2020
Certification Date: 05/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 NW 67TH AVE STE 306
MIAMI LAKES FL
33014-2176
US

IV. Provider business mailing address

7149 NW 127TH WAY
PARKLAND FL
33076-1982
US

V. Phone/Fax

Practice location:
  • Phone: 305-828-8260
  • Fax:
Mailing address:
  • Phone: 954-854-0892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOEL SALAMON
Title or Position: OWNER
Credential: MD
Phone: 954-854-0892