Organization
TAMPA INTERVENTIONAL SPINE PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KORTNI FLYNN (OWNER)
(989) 714-1839
Entity
Organization
Contact information
Practice address
1000 W KENNEDY BLVD, SUITE 201, TAMPA, FL 33606-1940
(813) 258-2225
(813) 258-8118
Mailing address
1000 W KENNEDY BLVD, SUITE 201, TAMPA, FL 33606-1940
(813) 258-2225
(813) 258-8118
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
98264
FL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
105149
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
105149
FL
Other
Enumeration date
12/06/2012
Last updated
12/07/2012
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