Provider Demographics
NPI:1356636955
Name:THE BROWARD CENTER FOR PAIN AND INJURY, LLC
Entity type:Organization
Organization Name:THE BROWARD CENTER FOR PAIN AND INJURY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:VULGAMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-640-4040
Mailing Address - Street 1:2450 N POWERLINE RD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-1051
Mailing Address - Country:US
Mailing Address - Phone:954-776-1880
Mailing Address - Fax:954-776-1808
Practice Address - Street 1:2450 N POWERLINE RD
Practice Address - Street 2:SUITE 26
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-1051
Practice Address - Country:US
Practice Address - Phone:954-776-1880
Practice Address - Fax:954-776-1808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7927111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL382263000Medicaid