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General NPI Number Information
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NPI Number | 1205367810
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Entity Type | Organization
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Legal Business Name | SOUTH BROWARD PAIN & REHABILITATION INC
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 4343 S STATE ROAD 7 SUITE 108
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City | DAVIE
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State | FL
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Zip | 33314-4009
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Country | US
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Telephone | 954-581-3958
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Fax |
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Provider Business Mailing Address
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Address Line | 307 VIA DE PALMAS
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City | BOCA RATON
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State | FL
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Zip | 33432-6007
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Country | US
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Telephone | 561-750-5416
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN CANTOR
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Credential | DC
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Telephone | 561-750-5416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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