Provider Demographics
NPI:1689294621
Name:ADVANCED PAIN MANAGEMENT AND WELLNESS CENTER
Entity Type:Organization
Organization Name:ADVANCED PAIN MANAGEMENT AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUFAIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-944-5534
Mailing Address - Street 1:3385 BURNS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4328
Mailing Address - Country:US
Mailing Address - Phone:561-944-5534
Mailing Address - Fax:
Practice Address - Street 1:3385 BURNS RD STE 101
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4328
Practice Address - Country:US
Practice Address - Phone:561-944-5534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-20
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty