Provider Demographics
NPI:1205214947
Name:COMPREHENSIVE PAIN OF THE PALM BEACHES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN OF THE PALM BEACHES LLC
Other - Org Name:COMPREHENSIVE PAIN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BART
Authorized Official - Middle Name:G
Authorized Official - Last Name:GATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-434-7577
Mailing Address - Street 1:4897 S JOG RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33467-5000
Mailing Address - Country:US
Mailing Address - Phone:561-434-7577
Mailing Address - Fax:561-434-3440
Practice Address - Street 1:4897 S JOG RD
Practice Address - Street 2:SUITE B
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-5000
Practice Address - Country:US
Practice Address - Phone:561-434-7577
Practice Address - Fax:561-434-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0076064208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIL799AOtherMEDICARE PTAN