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General NPI Number Information
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NPI Number | 1255697058
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Entity Type | Organization
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Legal Business Name | MIAMI INTERVENTIONAL PAIN AND REHABILITATION INC
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 748 SEVILLA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-5628
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Country | US
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Telephone | 305-702-9441
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Fax |
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Provider Business Mailing Address
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Address Line | 748 SEVILLA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-5628
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Country | US
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Telephone | 305-702-9441
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN A SERPA
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Credential | MD
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Telephone | 305-702-9441
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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 | ME79847
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License Number State | FL
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