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General NPI Number Information
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NPI Number | 1225234438
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Entity Type | Organization
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Legal Business Name | RELIEF PAIN DIAGNOSTIC CENTER, INC.
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3900 NW 79 AVE SUITE 219
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City | DORAL
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State | FL
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Zip | 33166-6546
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Country | US
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Telephone | 305-599-8800
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Fax | 305-599-8806
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Provider Business Mailing Address
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Address Line | 3900 NW 79 AVE SUITE 219
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City | DORAL
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State | FL
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Zip | 33166-6546
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Country | US
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Telephone | 305-599-8800
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Fax | 305-599-8806
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAMIRO GOMEZ
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Credential | MT
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Telephone | 305-599-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | MM 17707
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License Number State | FL
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