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NPI Code Detail

MEDICARE: TAMPA PAIN RELIEF CENTER, INC.

MEDICARE: TAMPA PAIN RELIEF CENTER, INC.
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
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician
2207LP2900XPain Medicine (Anesthesiology) 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 : 1780865618
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAMPA PAIN RELIEF CENTER, INC.
Provider Business Mailing Address
First Line : 4919 MEMORIAL HWY STE 200
Second Line :
City : TAMPA
State : FL
Zip : 33634-7500
Country : US
Telephone Number : 813-569-6500
Fax Number :
Provider Business Practice Location Address
First Line : 3000 MEDICAL PARK DR STE 510
Second Line :
City : TAMPA
State : FL
Zip : 33613-6602
Country : US
Telephone Number : 813-569-6500
Fax Number :
Authorized Official
Title or Position : OFFICER AND AUTHORIZED OFFICIAL
Name : JENNIFER BOYD BALDOCK
Credential :
Telephone Number : 615-234-5900
Provider Enumeration Date : 11/20/2007
Last Update Date : 05/06/2019

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Directions to “TAMPA PAIN RELIEF CENTER, INC. ” Practice Location

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