Organization
UNIVERSITY PAIN ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY N. KOZLOV D.O. (PRESIDENT & MANAGING MEMBER)
(727) 822-3500
Entity
Organization
Contact information
Practice address
431 SOUTHWEST BLVD N, ST PETERSBURG, FL 33703-1399
(727) 822-3500
(727) 822-3228
Mailing address
204 37TH AVE N, #125, ST PETERSBURG, FL 33704-1416
(727) 822-3500
(727) 822-3228
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
OS11865
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
OS11865
FL
Other
Enumeration date
10/15/2013
Last updated
10/15/2013
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