Healthcare Provider Details

I. General information

NPI: 1346426780
Provider Name (Legal Business Name): ARTHRITIS PAIN TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 GRAND CENTRAL ST
CLEARWATER FL
33756-3412
US

IV. Provider business mailing address

PO BOX 2796
CLEARWATER FL
33757-2796
US

V. Phone/Fax

Practice location:
  • Phone: 727-723-1454
  • Fax: 727-723-2950
Mailing address:
  • Phone: 727-723-1454
  • Fax: 727-723-2950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1641332
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberARNP1641332
License Number StateFL

VIII. Authorized Official

Name: MS. SALLY MARLOWE
Title or Position: CEO
Credential: ARNP
Phone: 727-723-1454