Provider Demographics
NPI:1922612373
Name:TOTAL PAIN AND SPINE CARE OF FLORIDA LLC
Entity Type:Organization
Organization Name:TOTAL PAIN AND SPINE CARE OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-732-7246
Mailing Address - Street 1:3818 W VASCONIA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8630
Mailing Address - Country:US
Mailing Address - Phone:863-732-7246
Mailing Address - Fax:863-256-2520
Practice Address - Street 1:2310 NORTH BLVD W STE A
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-8988
Practice Address - Country:US
Practice Address - Phone:863-732-7246
Practice Address - Fax:863-256-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty