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General NPI Number Information
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NPI Number | 1396638789
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Entity Type | Organization
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Legal Business Name | NORTH COAST PAIN CENTER SRL
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | CALLE CAMINO DEL SOL PLAZA SOL TROPICAL , LOCAL #5 CALLE CAMINO DEL SOL PLAZA SOL TROPICAL , LOCAL #5
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City | CABARETE
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State | DOMINICAN REPUBLIC
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Zip | 57111
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Country | DO
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Telephone | 849-506-4223
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Fax |
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Provider Business Mailing Address
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Address Line | 8400 NW 25TH ST STE 100
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City | DORAL
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State | FL
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Zip | 33198-1534
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Country | US
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Telephone | 214-718-5922
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SANDY A GLASS
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Credential |
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Telephone | 849-506-4223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care 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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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