Organization
PREMIER PAIN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINEDTY CORDOVA APRN (OWNER)
(754) 888-9080
Entity
Organization
Contact information
Practice address
9050 PINES BLVD STE 301, PEMBROKE PINES, FL 33024-6422
(754) 888-9080
(754) 888-9280
Mailing address
9050 PINES BLVD STE 301, PEMBROKE PINES, FL 33024-6422
(754) 888-9080
(754) 888-9280
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
10/23/2023
Last updated
10/24/2023
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