Provider Demographics
NPI:1659872661
Name:COMPREHENSIVE PAIN AND WELLNESS, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN AND WELLNESS, LLC
Other - Org Name:FLORIDA COMPREHENSIVE PAIN AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PHUNG
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-326-2781
Mailing Address - Street 1:333 NW 70TH AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2358
Mailing Address - Country:US
Mailing Address - Phone:954-998-6359
Mailing Address - Fax:954-756-9999
Practice Address - Street 1:333 NW 70TH AVE STE 107
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2358
Practice Address - Country:US
Practice Address - Phone:954-998-6359
Practice Address - Fax:954-756-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-24
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty