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NPI Code Detail

MEDICARE: CERTIFIED SPINE AND PAIN CARE

MEDICARE: CERTIFIED SPINE AND PAIN CARE
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
1207LP2900XPain Medicine (Anesthesiology) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942743554
Entity Type Code : Organization
Provider Name (Legal Business Name) : CERTIFIED SPINE AND PAIN CARE
Provider Business Mailing Address
First Line : 1049 S STATE ROAD 7
Second Line :
City : WELLINGTON
State : FL
Zip : 33414-6135
Country : US
Telephone Number : 561-578-4582
Fax Number :
Provider Business Practice Location Address
First Line : 1600 S FEDERAL HWY STE 611
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33062-7518
Country : US
Telephone Number : 561-578-4582
Fax Number : 561-432-4843
Authorized Official
Title or Position : CREDENTIALLING DIRECTOR
Name : JORGE GARCIA
Credential :
Telephone Number : 561-537-4526
Provider Enumeration Date : 11/30/2016
Last Update Date : 02/18/2023

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Directions to “CERTIFIED SPINE AND PAIN CARE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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