Healthcare Provider Details

I. General information

NPI: 1295771731
Provider Name (Legal Business Name): COMPREHENSIVE PAIN MANAGEMENT PARTNERS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4807 US HIGHWAY 19 STE 102
NEW PORT RICHEY FL
34652-4260
US

IV. Provider business mailing address

4807 US HIGHWAY 19 STE 102
NEW PORT RICHEY FL
34652-4260
US

V. Phone/Fax

Practice location:
  • Phone: 727-846-7618
  • Fax: 727-849-7090
Mailing address:
  • Phone: 727-846-7618
  • Fax: 727-849-7090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC R HAYNES
Title or Position: OWNER
Credential: MD
Phone: 727-846-7618