Provider Demographics
NPI:1316790355
Name:HEADACHE AND PAIN CLINIC INC
Entity type:Organization
Organization Name:HEADACHE AND PAIN CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AWSS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-239-9455
Mailing Address - Street 1:6141 SW 72ND ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5026
Mailing Address - Country:US
Mailing Address - Phone:305-239-9455
Mailing Address - Fax:305-686-1950
Practice Address - Street 1:6141 SW 72ND ST STE 400
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5026
Practice Address - Country:US
Practice Address - Phone:305-239-9455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty