Organization
45TH ST PAIN MANAGEMENT LLC
Active
Organization
45TH ST PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARDY D MARCELIN MD (CEO)
(561) 469-2635
Entity
Organization
Contact information
Practice address
5642 CORPORATE WAY, WEST PALM BEACH, FL 33407-2002
(561) 469-2635
(561) 469-2614
Mailing address
5642 CORPORATE WAY, WEST PALM BEACH, FL 33407-2002
(561) 469-2635
(561) 469-2614
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME97529
FL
208VP0000X
Pain Medicine Physician
ME97529
FL
Other
Enumeration date
08/16/2015
Last updated
08/16/2015
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