Organization
TAMPA PAIN RELIEF CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5900
Entity
Organization
Contact information
Practice address
3000 MEDICAL PARK DR STE 510, TAMPA, FL 33613-6602
(813) 569-6500
Mailing address
4919 MEMORIAL HWY STE 200, TAMPA, FL 33634-7500
(813) 569-6500
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262580601
—
FL
Enumeration date
11/20/2007
Last updated
05/06/2019
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