Organization
INTERVENTIONAL PAIN MANAGEMENT AND REGENERATIVE MEDICINE OF THE PALM B
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUMBERTO PORRATA NIEVA MD (OWNER)
(561) 436-5904
Entity
Organization
Contact information
Practice address
3319 S STATE ROAD 7 STE 102, WELLINGTON, FL 33449-8099
(561) 436-5904
Mailing address
3319 S STATE ROAD 7 STE 102, WELLINGTON, FL 33449-8099
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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