# SPINE DIAGNOSTICS & INTERVENTIONAL CENTER INC

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

## Provider details

- **NPI number:** 1700827649
- **Authorized official:** DR. GREGORY T FLYNN M.D. (OWNER/MEDICAL DIRECTOR)
- **Authorized official phone:** (813) 872-9200

## Contact information

- **Practice address:** 2808 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6306
- **Practice address phone:** (813) 872-9200
- **Practice address fax:** (813) 875-5101
- **Mailing address:** PO BOX 152199, TAMPA, FL 33684-2199
- **Mailing address phone:** (813) 872-9200
- **Mailing address fax:** (813) 875-5101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | ME37627 | FL | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 03/09/2009