Provider Demographics
NPI:1760587547
Name:JOHN E BARSA, M.D., PA
Entity Type:Organization
Organization Name:JOHN E BARSA, M.D., PA
Other - Org Name:THE PAIN INSTITUTE OF TAMPA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-879-7382
Mailing Address - Street 1:4178 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607
Mailing Address - Country:US
Mailing Address - Phone:813-879-7382
Mailing Address - Fax:813-873-2496
Practice Address - Street 1:4178 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-879-7382
Practice Address - Fax:813-873-2496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOSR#519174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3556Medicare ID - Type Unspecified