Provider Demographics
NPI:1477734002
Name:REHABILITATION PAIN AND ACUPUNCTURE CENTER,LLC
Entity Type:Organization
Organization Name:REHABILITATION PAIN AND ACUPUNCTURE CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-910-1606
Mailing Address - Street 1:14509 UNIVERSITY POINT PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-5424
Mailing Address - Country:US
Mailing Address - Phone:813-910-1606
Mailing Address - Fax:
Practice Address - Street 1:14509 UNIVERSITY POINT PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-5424
Practice Address - Country:US
Practice Address - Phone:813-910-1606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1477734002OtherNPI
FLK6146Medicare PIN