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Organization
WEST FLORIDA PAIN MANAGEMENT PA
Active
Organization
WEST FLORIDA PAIN MANAGEMENT PA
Active
Other names
Minimally Invasive Spine Care
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GENE MONTGOMERY (ADMINISTRATOR)
(727) 317-5603
Entity
Organization
Contact information
Practice address
603 7TH ST S STE 320, ST PETERSBURG, FL 33701
(727) 553-7313
(727) 553-7320
Mailing address
PO BOX 919017, LOCK BOX 9017, ORLANDO, FL 32891-9017
(727) 553-7313
(727) 553-7320
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K0997
PTAN
FL
Enumeration date
07/05/2006
Last updated
06/04/2018
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