Provider Demographics
NPI:1336457084
Name:ABDOMINAL PAIN SOLUTIONS OF FLORIDA
Entity Type:Organization
Organization Name:ABDOMINAL PAIN SOLUTIONS OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:RICHARDSON
Authorized Official - Last Name:NOBACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-337-3509
Mailing Address - Street 1:5700 MIDNIGHT PASS RD
Mailing Address - Street 2:ST. 4
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34242-3083
Mailing Address - Country:US
Mailing Address - Phone:888-337-3509
Mailing Address - Fax:941-328-3997
Practice Address - Street 1:3885 OAKWATER CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6257
Practice Address - Country:US
Practice Address - Phone:407-438-9533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Multi-Specialty