Healthcare Provider Details

I. General information

NPI: 1477585883
Provider Name (Legal Business Name): CLEARWATER PAIN MANAGEMENT ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 05/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 MORTON PLANT ST SUITE 210
CLEARWATER FL
33756-3398
US

IV. Provider business mailing address

300 JEFFORDS ST SUITE B
CLEARWATER FL
33756-3810
US

V. Phone/Fax

Practice location:
  • Phone: 727-446-4506
  • Fax: 727-446-4695
Mailing address:
  • Phone: 727-441-1524
  • Fax: 727-443-4206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWARD CHEN
Title or Position: PHYSICIAN
Credential: MD
Phone: 727-446-4506