Provider Demographics
NPI:1730288176
Name:FLORIDA PAIN MANAGEMENT
Entity Type:Organization
Organization Name:FLORIDA PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAZI
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-548-6100
Mailing Address - Street 1:6333 54TH AVENUE NORTH
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709
Mailing Address - Country:US
Mailing Address - Phone:727-548-6100
Mailing Address - Fax:727-545-0960
Practice Address - Street 1:6333 54TH AVENUE NORTH
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709
Practice Address - Country:US
Practice Address - Phone:727-548-6100
Practice Address - Fax:727-545-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2973Medicare PIN