=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982431268
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CINTEX INJURY CLINIC FL, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2024
-----------------------------------------------------
Last Update Date | 07/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3601 W COMMERCIAL BLVD STE 22
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33309-3320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-717-3376
-----------------------------------------------------
Fax | 912-600-1298
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3121 W HALLANDALE BEACH BLVD STE 105
-----------------------------------------------------
City | HALLANDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33009-5149
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JENNIFER CHARLES
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 908-803-6363
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208VP0014X
-----------------------------------------------------
Taxonomy Name | Interventional Pain Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208VP0000X
-----------------------------------------------------
Taxonomy Name | Pain Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------