| NPI | 1164205100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK BRENNAN Officer 786-717-0753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2025-06-20 |