Organization
COASTAL INTERVENTIONAL PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER M BURNS MD (OWNER)
(727) 822-7000
Entity
Organization
Contact information
Practice address
1099 5TH AVE N, STE 320, ST PETERSBURG, FL 33705-1469
(727) 822-7000
(727) 822-7001
Mailing address
1099 5TH AVE N, STE 320, ST PETERSBURG, FL 33705-1469
(727) 822-7000
(727) 822-7001
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34087
BS FLORIDA
FL
Enumeration date
11/02/2009
Last updated
03/03/2011
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