Provider Demographics
NPI:1356518393
Name:MARGATE PAIN & REHABILITATION INC
Entity type:Organization
Organization Name:MARGATE PAIN & REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:FEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-466-5665
Mailing Address - Street 1:1814 NE MIAMI GARDENS DR # 1103
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-5043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6538 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5135
Practice Address - Country:US
Practice Address - Phone:954-917-1200
Practice Address - Fax:954-917-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU878280001Medicare UPIN