Provider Demographics
NPI:1386837862
Name:PINNACLE INJURY CTR INC
Entity Type:Organization
Organization Name:PINNACLE INJURY CTR INC
Other - Org Name:NEESE MEDICAL CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:NEESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-598-4047
Mailing Address - Street 1:PO BOX 340364
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624
Mailing Address - Country:US
Mailing Address - Phone:813-598-4047
Mailing Address - Fax:
Practice Address - Street 1:2904 W COLUMBUS DR
Practice Address - Street 2:SUITE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-872-1900
Practice Address - Fax:813-876-3425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS3968208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OS0003968OtherFAMILY PRACTICE I L LICEN