# TEA PAIN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063038719
- **Authorized official:** RATIBU GOMANGO (MGR)
- **Authorized official phone:** (404) 488-6907

## Contact information

- **Practice address:** 6220 S ORANGE BLOSSOM TRL, ORLANDO, FL 32809-4630
- **Practice address phone:** (404) 488-6907
- **Mailing address:** 7612 SUN VISTA WAY, ORLANDO, FL 32822-7501
- **Mailing address phone:** (404) 488-6907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 06/18/2020
- **Last updated:** 06/18/2020