Healthcare Provider Details

I. General information

NPI: 1588852776
Provider Name (Legal Business Name): FLORIDA MEDICAL PAIN MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 54TH AVE NORTH
SAINT PETERSBURG FL
33709-1703
US

IV. Provider business mailing address

6333 54TH AVE NORTH
SAINT PETERSBURG FL
33709-1703
US

V. Phone/Fax

Practice location:
  • Phone: 727-548-6100
  • Fax: 727-545-0960
Mailing address:
  • Phone: 727-548-6100
  • Fax: 727-545-0960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KAZI M HASSAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 727-548-6100