Healthcare Provider Details

I. General information

NPI: 1356636955
Provider Name (Legal Business Name): THE BROWARD CENTER FOR PAIN AND INJURY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 N POWERLINE RD SUITE 26
POMPANO BEACH FL
33069-1051
US

IV. Provider business mailing address

2450 N POWERLINE RD SUITE 26
POMPANO BEACH FL
33069-1051
US

V. Phone/Fax

Practice location:
  • Phone: 954-776-1880
  • Fax: 954-776-1808
Mailing address:
  • Phone: 954-776-1880
  • Fax: 954-776-1808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH7927
License Number StateFL

VIII. Authorized Official

Name: MS. KAREN VULGAMORE
Title or Position: MANAGER
Credential:
Phone: 954-640-4040