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NPI Code Detail

MEDICARE: TRANSITIONAL PAIN & SPECIALTY GROUP

MEDICARE: TRANSITIONAL PAIN & SPECIALTY GROUP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center
2208100000XPhysical Medicine & Rehabilitation Physician
3208VP0014XInterventional Pain Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205569233
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANSITIONAL PAIN & SPECIALTY GROUP
Provider Business Mailing Address
First Line : 23110 STATE ROAD 54 STE 446
Second Line :
City : LUTZ
State : FL
Zip : 33549-6933
Country : US
Telephone Number : 813-295-6809
Fax Number :
Provider Business Practice Location Address
First Line : 1307 W KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33606-1848
Country : US
Telephone Number : 813-495-5567
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. RICHA SUTARIA
Credential :
Telephone Number : 813-295-6809
Provider Enumeration Date : 07/07/2022
Last Update Date : 07/17/2025

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Directions to “TRANSITIONAL PAIN & SPECIALTY GROUP ” Practice Location

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