NPIMap

Organization Active NPI

Certified Spine and Pain Care LLC

  • Interventional Pain Medicine Physician
  • Wellington, FL
National Provider Identifier
1689049900
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
CERTIFIED SPINE AND PAIN CARE LLC
Practice address
1049 S State Road 7
Wellington, FL 33414-6135
Phone
(561) 578-4582
Fax
(561) 828-2377
NPI assigned
Dec 11, 2015
Last updated
Apr 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Authorized official

Name
Dr. Edwin W Maldonado, MDNPI 1184648362
Title
Owner
Phone
(954) 376-9281

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X FL Primary

Addresses

Primary practice location

1049 S State Road 7
Wellington, FL 33414-6135

Mailing address

1049 S State Road 7
Wellington, FL 33414-6135
Phone (954) 376-9281

Other practice location 1

1600 S Federal Hwy Ste 611
Pompano Beach, FL 33062-7518
Phone (561) 578-4582

Other practice location 2

9325 Glades Rd Ste 104
Boca Raton, FL 33434-3988
Phone (561) 578-4582

Other practice location 3

1100 S Main St Ste 103
Belle Glade, FL 33430-4910
Phone (561) 578-4582

Other practice location 4

3335 Burns Rd Ste 300
Palm Beach Gardens, FL 33410-4311
Phone (561) 537-4526

National Provider Directory

National Provider Directory
Tax ID family
Certified Spine and Pain Care LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

6415 Lake Worth Rd
Ste 307
Greenacres, FL 33463
Phone (561) 327-6977

3335 Burns Rd
Ste 300
Palm Beach Gardens, FL 33410

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1689049900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 S STATE ROAD 7",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146135",
            "telephone_number": "954-376-9281",
            "fax_number": "561-828-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 S STATE ROAD 7",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146135",
            "telephone_number": "561-578-4582",
            "fax_number": "561-828-2377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 S Federal Hwy Ste 611",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330627518",
            "country_code": "US",
            "telephone_number": "561-578-4582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9325 Glades Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334343988",
            "country_code": "US",
            "telephone_number": "561-578-4582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 S Main St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Belle Glade",
            "state": "FL",
            "postal_code": "334304910",
            "country_code": "US",
            "telephone_number": "561-578-4582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3335 Burns Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334104311",
            "country_code": "US",
            "telephone_number": "561-537-4526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CERTIFIED SPINE AND PAIN CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "MALDONADO",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-376-9281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.