Healthcare Provider Details

I. General information

NPI: 1306820733
Provider Name (Legal Business Name): INTERVENTIONAL REHABILITATION OF SOUTH FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 NW 170TH ST
NORTH MIAMI BEACH FL
33169-5521
US

IV. Provider business mailing address

PO BOX 452439
SUNRISE FL
33345-2439
US

V. Phone/Fax

Practice location:
  • Phone: 305-654-6855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GILBERT DROZDOW
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-838-2371