Healthcare Provider Details

I. General information

NPI: 1689294621
Provider Name (Legal Business Name): ADVANCED PAIN MANAGEMENT AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3385 BURNS RD STE 101
PALM BEACH GARDENS FL
33410-4328
US

IV. Provider business mailing address

3385 BURNS RD STE 101
PALM BEACH GARDENS FL
33410-4328
US

V. Phone/Fax

Practice location:
  • Phone: 561-944-5534
  • Fax:
Mailing address:
  • Phone: 561-944-5534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID ROUFAIEL
Title or Position: PHYSICIAN
Credential: MD
Phone: 561-944-5534