NPIMap

Organization Active NPI

Blue Water Pain Solutions, PA

  • Pain Medicine Physician
  • Hollywood, FL
National Provider Identifier
1528508090
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
BLUE WATER PAIN SOLUTIONS, PA
Practice address
2 Oakwood Blvd
Suite 195
Hollywood, FL 33020-1960
Phone
(954) 447-5206
NPI assigned
Mar 3, 2017
Last updated
Mar 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert J Coward
Title
President
Phone
(954) 838-2371

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

2 Oakwood Blvd
Suite 195
Hollywood, FL 33020-1960

Mailing address

PO Box 277597
Miramar, FL 33027-7597

National Provider Directory

National Provider Directory
Tax ID family
Blue Water Pain Solutions P5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488499200000",
    "number": "1528508090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277597",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330277597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OAKWOOD BLVD",
            "address_2": "SUITE 195",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201960",
            "telephone_number": "954-447-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER PAIN SOLUTIONS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-03-03",
        "status": "A",
        "authorized_official_last_name": "COWARD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-838-2371"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.