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Organization

SAINT PETERSBURG INTERVENTIONAL PAIN MANAGEMENT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANYA ALIDA GODOY M.D. (DOCTOR)
(172) 714-8573
Entity
Organization

Contact information

Practice address
620 10TH ST N, SUITE 2D, ST PETERSBURG, FL 33705-1407
(727) 824-8383
Mailing address
620 10TH ST NORTH, 2D, SAINT PETERSBURG, FL 33704
(727) 824-8383

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
ME85040
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269485900
FL
Enumeration date
12/10/2015
Last updated
12/10/2015
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