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NPI Code Detail

MEDICARE: COMPREHENSIVE PAIN OF THE PALM BEACHES PLLC

MEDICARE: COMPREHENSIVE PAIN OF THE PALM BEACHES PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0014XInterventional Pain Medicine PhysicianME0076064FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1IL799AOTHERFLMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205214947
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE PAIN OF THE PALM BEACHES PLLC
Provider Business Mailing Address
First Line : 4897 S JOG RD
Second Line : SUITE B
City : GREENACRES
State : FL
Zip : 33467-5000
Country : US
Telephone Number : 561-434-7577
Fax Number : 561-434-3440
Provider Business Practice Location Address
First Line : 4897 S JOG RD
Second Line : SUITE B
City : GREENACRES
State : FL
Zip : 33467-5000
Country : US
Telephone Number : 561-434-7577
Fax Number : 561-434-3440
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : MR. BART G GATZ
Credential : M.D.
Telephone Number : 561-434-7577
Provider Enumeration Date : 05/14/2015
Last Update Date : 09/26/2024

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Directions to “COMPREHENSIVE PAIN OF THE PALM BEACHES PLLC ” Practice Location

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