Healthcare Provider Details

I. General information

NPI: 1164205100
Provider Name (Legal Business Name): ESSENTIAL PAIN MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MERCY PROFESSIONAL BUILDING I 3661 SOUTH MIAMI AVENUE, STE 504
MIAMI FL
33133
US

IV. Provider business mailing address

MERCY PROFESSIONAL BUILDING I 3661 SOUTH MIAMI AVENUE, STE 504
MIAMI FL
33133
US

V. Phone/Fax

Practice location:
  • Phone: 786-717-0753
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICK BRENNAN
Title or Position: OFFICER
Credential: DO
Phone: 786-717-0753