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General NPI Number Information
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NPI Number | 1932229010
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Entity Type | Organization
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Legal Business Name | TOTAL PAIN CARE
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 440 E SAMPLE RD SUITE 101
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City | POMPANO BEACH
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State | FL
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Zip | 33064-4444
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Country | US
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Telephone | 954-788-9003
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Fax | 954-788-9631
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Provider Business Mailing Address
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Address Line | 440 E SAMPLE RD SUITE 101
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City | POMPANO BEACH
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State | FL
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Zip | 33064-4444
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Country | US
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Telephone | 954-788-9003
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Fax | 954-788-9631
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Authorized Official
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Title or Position | PROVIDERPHYSCIAN
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Name | ADEL AYAD KALLINI
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Credential | MD
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Telephone | 954-788-9003
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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 | ME32795
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License Number State | FL
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