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General NPI Number Information
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NPI Number | 1053439109
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Entity Type | Organization
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Legal Business Name | HOLLYWOOD PAIN MANAGEMENT CENTERS, LLC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2464 N UNIVERSITY DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3624
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Country | US
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Telephone | 954-885-9874
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Fax | 954-885-9876
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Provider Business Mailing Address
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Address Line | 2464 N UNIVERSITY DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3624
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Country | US
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Telephone | 954-885-9874
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Fax | 954-885-9876
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Authorized Official
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Title or Position | MANAGER
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Name | DR. JOSEPH MANUEL OSSORIO
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Credential | M.D.
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Telephone | 954-885-9874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number |
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License Number State | FL
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