| West Pompano Spine Center Llc | |
|
2400 W Sample Rd Ste 4 Pompano Beach FL 33073-3035 | |
| (954) 636-1922 | |
| (954) 636-1925 |
| Full Name | West Pompano Spine Center Llc |
|---|---|
| Speciality | Pain Medicine |
| Location | 2400 W Sample Rd Ste 4, Pompano Beach, Florida |
| Authorized Official Name and Position | Regiane Goelz (OWNER) |
| Authorized Official Contact | 9546703221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Pompano Spine Center Llc 2400 W Sample Rd Ste 4 Pompano Beach FL 33073-3035 Ph: (954) 636-1922 | West Pompano Spine Center Llc 2400 W Sample Rd Ste 4 Pompano Beach FL 33073-3035 Ph: (954) 636-1922 |
| NPI Number | 1225817117 |
|---|---|
| Provider Enumeration Date | 09/28/2023 |
| Last Update Date | 09/10/2024 |
| Medicare PECOS PAC ID | 4486092988 |
|---|---|
| Medicare Enrollment ID | O20240403001132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225817117 | NPI | - | NPPES |
| Provider Name | Eric F Holt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194875344 PECOS PAC ID: 2365532587 Enrollment ID: I20071212000145 |
| Provider Name | Jack Miletic |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1982872990 PECOS PAC ID: 7012040686 Enrollment ID: I20100803000479 |
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