Provider Demographics
NPI:1225234438
Name:RELIEF PAIN DIAGNOSTIC CENTER, INC.
Entity Type:Organization
Organization Name:RELIEF PAIN DIAGNOSTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:305-599-8800
Mailing Address - Street 1:3900 NW 79 AVE
Mailing Address - Street 2:SUITE 219
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6546
Mailing Address - Country:US
Mailing Address - Phone:305-599-8800
Mailing Address - Fax:305-599-8806
Practice Address - Street 1:3900 NW 79 AVE
Practice Address - Street 2:SUITE 219
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6546
Practice Address - Country:US
Practice Address - Phone:305-599-8800
Practice Address - Fax:305-599-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM 17707261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy