Organization
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC
Active
Organization
NEW TAMPA INTERVENTIONAL PAIN AND SPORTS MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE DE LA TORRE M.D. (OWNER)
(813) 309-1013
Entity
Organization
Contact information
Practice address
2014 ASHLEY OAKS CIR, SUITE 101, WESLEY CHAPEL, FL 33544-6400
(813) 999-3030
Mailing address
2014 ASHLEY OAKS CIR, SUITE 101, WESLEY CHAPEL, FL 33544-6400
(813) 999-3030
(813) 991-7377
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME89848
FL
208VP0014X
Interventional Pain Medicine Physician
ME89848
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269279100
—
FL
01
—
P00400544
RR MEDICARE
FL
Enumeration date
11/18/2013
Last updated
12/09/2013
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