1932406451 NPI number — PAIN THERAPY CENTER OF SOUTH MIAMI INC

Table of content: GUNNAR LAURENCE HAUSER DPT (NPI 1215816095)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932406451 NPI number — PAIN THERAPY CENTER OF SOUTH MIAMI INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAIN THERAPY CENTER OF SOUTH MIAMI INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932406451
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7400 N KENDALL DR
Provider Second Line Business Mailing Address:
SUITE 404A
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33156-7706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-218-0546
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7400 N KENDALL DR
Provider Second Line Business Practice Location Address:
SUITE 404A
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33156-7706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-218-0546
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
RENE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-218-0546

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA37431 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com