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General NPI Number Information
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NPI Number | 1922037290
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Entity Type | Organization
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Legal Business Name | PAIN MANAGEMENT PHYSICIANS OF SOUTH FLORIDA, P.L.
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 8880 ROYAL PALM BLVD SUITE 103
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5727
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Country | US
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Telephone | 954-975-8233
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Fax | 954-974-2335
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Provider Business Mailing Address
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Address Line | 6295 NW 96TH TER
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City | PARKLAND
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State | FL
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Zip | 33076-1815
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Country | US
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Telephone | 954-605-3724
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Fax | 954-255-9147
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW JAY GOLDBERG
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Credential | M.D.
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Telephone | 954-605-3724
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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 | ME 66192
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License Number State | FL
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