Organization · NPI-2

Blue Water Pain Solutions, PA

Anesthesiology, Pain Medicine · Hollywood, FL

NPI number1235533696
StatusActive
Last updated in NPPESOct 14, 2014

Details

NPI
1235533696
Entity type
Organization (NPI-2)
Legal business name
Blue Water Pain Solutions, PA
Organization subpart
No
Enumeration date
Oct 14, 2014
Last updated
Oct 14, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207LP2900X Anesthesiology, Pain Medicine––Yes

Practice location

4925 Sheridan St
Suite 200
Hollywood, FL 33021-2834

Phone 954-447-5206

Mailing address

Po Box 277597
Miramar, FL 33027-7597

Phone 800-437-2672

Authorized official

Lowell S. Davis
President
9544475206

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