Professional Pain Management Clinic Inc

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

PROFESSIONAL PAIN MANAGEMENT CLINIC INC

Practice address

3267 Davie Blvd
Fort Lauderdale, FL 33312

Phone

(954) 584-7009

Fax

(954) 584-7209

NPI assigned

Jul 13, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Erez Cohen

Title

President

Phone

(954) 584-7009

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1942512447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3267 DAVIE BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33312",
            "telephone_number": "954-584-7009",
            "fax_number": "954-584-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3267 DAVIE BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33312",
            "telephone_number": "954-584-7009",
            "fax_number": "954-584-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PAIN MANAGEMENT CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-13",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "EREZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-584-7009",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS4663",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Clinic/Center in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Pain Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.