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General NPI Number Information
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NPI Number | 1750687927
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Entity Type | Organization
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Legal Business Name | BROAD PAIN CARE PHYSICIANS
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 501 GLADES RD
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City | BOCA RATON
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State | FL
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Zip | 33432-1419
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Country | US
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Telephone | 561-362-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 501 GLADES RD
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City | BOCA RATON
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State | FL
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Zip | 33432-1419
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Country | US
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Telephone | 561-362-4400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW ASTROVE
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Credential | MD
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Telephone | 908-653-9399
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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 |
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License Number State |
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