Organization
COASTAL PAIN MANAGEMENT POMPANO DISPENSARY
Active
Organization
COASTAL PAIN MANAGEMENT POMPANO DISPENSARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CICELY D EASON (EXECUTIVE ADMIN.)
(954) 935-6063
Entity
Organization
Contact information
Practice address
2301 W SAMPLE RD, SUITE 7A, POMPANO BEACH, FL 33073-3081
(954) 935-6063
Mailing address
2301 W SAMPLE RD, SUITE 7A, POMPANO BEACH, FL 33073-3081
(954) 935-6063
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME57886
FL
Other
Enumeration date
02/15/2008
Last updated
02/15/2008
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