Organization
SHILO LLC
Active
Other names
SHILOH MEDICAL GROUP, TAMPA PAIN CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN O BANJOKO (CFO)
(212) 257-0225
Entity
Organization
Contact information
Practice address
10549 N FLORIDA AVE STE J, TAMPA, FL 33612-6707
(813) 252-0242
Mailing address
PO BOX 17175, TAMPA, FL 33682-7175
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
01/05/2022
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