Healthcare Provider Details

I. General information

NPI: 1558106393
Provider Name (Legal Business Name): PIRRX OF SOUTH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 SW 12TH AVE STE 102B
POMPANO BEACH FL
33069-3593
US

IV. Provider business mailing address

555 SW 12TH AVE STE 102B
POMPANO BEACH FL
33069-3593
US

V. Phone/Fax

Practice location:
  • Phone: 216-313-0793
  • Fax:
Mailing address:
  • Phone: 216-313-0793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: GREGOIRE GASPARINI
Title or Position: OWNER/MANAGING EMPLOYEE
Credential:
Phone: 434-466-9094