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General NPI Number Information
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NPI Number | 1225817117
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Entity Type | Organization
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Legal Business Name | WEST POMPANO SPINE CENTER LLC
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Dates
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Enumeration Date | 09/28/2023
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 2400 W SAMPLE RD STE 4
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City | POMPANO BEACH
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State | FL
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Zip | 33073-3035
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Country | US
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Telephone | 954-636-1922
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Fax | 954-636-1925
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Provider Business Mailing Address
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Address Line | 2400 W SAMPLE RD STE 4
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City | POMPANO BEACH
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State | FL
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Zip | 33073-3035
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Country | US
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Telephone | 561-806-8306
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Fax | 954-580-1119
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Authorized Official
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Title or Position | OWNER
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Name | REGIANE GOELZ
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Credential |
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Telephone | 561-806-8306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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