| Organization Name: | PAIN DOCTOR CENTER INC |
| NPI Number: | 1255602462 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARTIN VALDES (PRESIDENT) |
| Mailing Address: | 5931 Nw 173rd Dr Ste 7b Hialeah |
| State: | FL US |
| Postal Code: | 330155106 |
| Phone Number: | 3058234002 |
| Fax Number: | |
| NPI Enumeration Date: | 01/19/2012 |
| NPI Last Update Date: | 06/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | HCC9547 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |