Organization
PREMIER PAIN MANAGEMENT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE DEBRA VICTOR M.D. (PRESIDENT/PHYSICIAN)
(973) 698-7768
Entity
Organization
Contact information
Practice address
3255 NW 94TH AVE, SUITE 9161, CORAL SPRINGS, FL 33075-2001
(973) 698-7768
Mailing address
PO BOX 9161, CORAL SPRINGS, FL 33075-9161
(973) 698-7768
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
ME100973
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164422705
NPI
FL
Enumeration date
04/14/2015
Last updated
04/14/2015
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