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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
2333 W HILLSBOROUGH AVE STE 100, TAMPA, FL 33603-1052
(813) 569-6500
Mailing address
4919 MEMORIAL HWY STE 200, TAMPA, FL 33634-7500
(813) 569-6500

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME0054890
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
064122700
FL
01
1024188
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
01/11/2007
Last updated
05/06/2019
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