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General NPI Number Information
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NPI Number | 1487664041
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL CENTER FOR PAIN MANAGEMENT INC
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 05/06/2010
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Provider Practice Location Address
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Address Line | 1151 BLACKWOOD AVE SUITE 150
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City | OCOEE
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State | FL
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Zip | 34761-4519
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Country | US
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Telephone | 407-296-1902
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Fax | 407-358-5366
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Provider Business Mailing Address
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Address Line | PO BOX 1507
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City | WINDERMERE
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State | FL
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Zip | 34786-1507
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Country | US
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Telephone | 407-296-1902
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Fax | 407-358-5366
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MUHAMMAD HASSAN SALEM
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Credential | M.D.
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Telephone | 407-296-1902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | ME83805
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License Number State | FL
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