Provider Demographics
NPI:1134591456
Name:BROWARD PAIN AND WELLNESS INC
Entity type:Organization
Organization Name:BROWARD PAIN AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYDMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:786-252-3397
Mailing Address - Street 1:2673 E. ATLANTIC BLVD.
Mailing Address - Street 2:#145
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062
Mailing Address - Country:US
Mailing Address - Phone:786-252-3397
Mailing Address - Fax:800-298-7337
Practice Address - Street 1:2745 E ATLANTIC BLVD
Practice Address - Street 2:SITE302
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-4952
Practice Address - Country:US
Practice Address - Phone:954-960-2227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty