Provider Demographics
NPI:1447599964
Name:NEURO PAIN MANAGEMENT, P.A.
Entity Type:Organization
Organization Name:NEURO PAIN MANAGEMENT, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KRONENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-358-1735
Mailing Address - Street 1:2754 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-2435
Mailing Address - Country:US
Mailing Address - Phone:954-358-1735
Mailing Address - Fax:
Practice Address - Street 1:2754 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-2435
Practice Address - Country:US
Practice Address - Phone:954-358-1735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME917582084N0400X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty