Provider Demographics
NPI:1477801777
Name:UNIVERSITY PAIN MANAGEMENT CENTER, PA
Entity Type:Organization
Organization Name:UNIVERSITY PAIN MANAGEMENT CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUKAT
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHOWDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-977-2222
Mailing Address - Street 1:11707 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5521
Mailing Address - Country:US
Mailing Address - Phone:813-977-2222
Mailing Address - Fax:813-977-4222
Practice Address - Street 1:11707 CLUB DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5521
Practice Address - Country:US
Practice Address - Phone:813-977-2222
Practice Address - Fax:813-977-4222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY PAIN MANAGEMENT CENTER, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-17
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site