Organization
PAIN TREATMENT SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOUMNA DISTEFANO MD (MANAGING DIRECTOR)
(617) 314-0603
Entity
Organization
Contact information
Practice address
2601 E OAKLAND PARK BLVD STE 200, FORT LAUDERDALE, FL 33306
(617) 314-0603
Mailing address
2601 E OAKLAND PARK BLVD STE 200, FORT LAUDERDALE, FL 33306-1612
(954) 500-7246
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME132254
FL
208VP0000X
Pain Medicine Physician
ME132254
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
ME132254
FL
Other
Enumeration date
05/31/2018
Last updated
06/05/2018
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