| NPI | 1104490671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAYTON ALEXANDER VARGA Manager Member 305-428-7730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2025-03-17 |