Provider Demographics
NPI:1235227026
Name:PAIN INSTITUTE OF TAMPA BAY PLC
Entity Type:Organization
Organization Name:PAIN INSTITUTE OF TAMPA BAY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:RAMIREZ-PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-977-6688
Mailing Address - Street 1:15303 AMBERLY DR STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2308
Mailing Address - Country:US
Mailing Address - Phone:813-977-6688
Mailing Address - Fax:813-977-6798
Practice Address - Street 1:15303 AMBERLY DR STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2308
Practice Address - Country:US
Practice Address - Phone:813-977-6688
Practice Address - Fax:813-977-6798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8446207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74524Medicare ID - Type Unspecified