| NPI | 1962351379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSON COLLINS BARTELL Credentialing Specialist 954-458-1199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2026-01-27 |
| Last Update Date | 2026-02-18 |