Provider Demographics
NPI:1073535894
Name:BAY AREA PAIN MANAGEMENT CENTER
Entity Type:Organization
Organization Name:BAY AREA PAIN MANAGEMENT CENTER
Other - Org Name:PAIN MANAGMENT PHYSICIANS OF FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-734-6934
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34697-0667
Mailing Address - Country:US
Mailing Address - Phone:727-734-6934
Mailing Address - Fax:727-736-6380
Practice Address - Street 1:646 VIRGINIA ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6612
Practice Address - Country:US
Practice Address - Phone:727-734-6934
Practice Address - Fax:727-736-6380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Not Answered208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL98811Medicare ID - Type Unspecified