MEDICARE: TAMPA ORTHOPEDIC & PAIN MGMT

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
1	174400000X	Specialist	ME39173	FL

General Provider Information

NPI Number	:	1942591219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA ORTHOPEDIC & PAIN MGMT

Provider Business Mailing Address
First Line	:	1931 W MARTIN LUTHER KING BLVD
Second Line	:	SUITE A
City	:	TAMPA
State	:	FL
Zip	:	33607
Country	:	US
Telephone Number	:	813-875-7246
Fax Number	:	813-875-7247

Provider Business Practice Location Address
First Line	:	1931 W MARTIN LUTHER KING BLVD
Second Line	:	SUITE A
City	:	TAMPA
State	:	FL
Zip	:	33607
Country	:	US
Telephone Number	:	813-875-7246
Fax Number	:	813-875-7247

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. FRANCISCO GOMEZ
Credential	:	M.D.
Telephone Number	:	813-875-7246

Provider Enumeration Date	:	04/21/2011
Last Update Date	:	04/21/2011

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