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General NPI Number Information
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NPI Number | 1124002639
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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 | 11/30/2005
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 2960 N STATE ROAD 7 SUITE 206
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City | MARGATE
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State | FL
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Zip | 33063-5755
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Country | US
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Telephone | 954-838-2756
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 744069
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City | ATLANTA
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State | GA
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Zip | 30374-4069
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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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