Healthcare Provider Details

I. General information

NPI: 1538325311
Provider Name (Legal Business Name): CENTER FOR QUALITY PAIN CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 SW 57TH AVE SUITE 201B
SOUTH MIAMI FL
33143-5528
US

IV. Provider business mailing address

PO BOX 879
HALLANDALE FL
33008-0879
US

V. Phone/Fax

Practice location:
  • Phone: 786-514-3290
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME95174
License Number StateFL

VIII. Authorized Official

Name: DR. ANDRE CHRISTOPHER HOBBS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 786-514-3290