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General NPI Number Information
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NPI Number | 1730153396
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PAIN MANAGEMENT CENTER INC
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 12/19/2013
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Provider Practice Location Address
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Address Line | 11707 CLUB DR
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City | TAMPA
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State | FL
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Zip | 33612-5521
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Country | US
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Telephone | 813-977-2222
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Fax | 813-977-4222
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Provider Business Mailing Address
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Address Line | PO BOX 46518
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City | TAMPA
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State | FL
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Zip | 33646-0105
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Country | US
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Telephone | 813-977-2222
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Fax | 813-977-4222
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SHAUKAT H CHOWDHARI
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Credential | M.D.
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Telephone | 813-977-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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