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General NPI Number Information
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NPI Number | 1104591189
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL REHABILITATION OF SOUTH FLORIDA, INC
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 1901 SW 172ND AVE
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City | MIRAMAR
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State | FL
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Zip | 33029-5592
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Country | US
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Telephone | 877-328-1119
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Fax |
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Provider Business Mailing Address
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Address Line | 5565 CENTERVIEW DR STE 107
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City | RALEIGH
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State | NC
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Zip | 27606-3563
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | KAREN VAUGHN
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Credential |
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Telephone | 404-450-4684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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