Organization
NEUROLOOGICIAL NEUROSURGICAL PAIN MANAGEMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD O GERSHANIK MD (PRESIDENT)
(305) 551-8127
Entity
Organization
Contact information
Practice address
8390 W FLAGLER ST, STE 107, MIAMI, FL 33144-2039
(305) 551-8121
(305) 551-7603
Mailing address
8390 W FLAGLER ST, STE 107, MIAMI, FL 33144-2039
(305) 551-8121
(305) 551-7603
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME0053136
FL. MEDICAL LICENSE
FL
Enumeration date
12/27/2005
Last updated
05/13/2008
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