Provider Demographics
NPI:1023467974
Name:PAIN AND SUPPORTIVE CARE, PA
Entity type:Organization
Organization Name:PAIN AND SUPPORTIVE CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SARRIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-399-2128
Mailing Address - Street 1:6612 THORNTON PALMS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-5104
Mailing Address - Country:US
Mailing Address - Phone:813-399-2128
Mailing Address - Fax:727-245-8661
Practice Address - Street 1:6612 THORNTON PALMS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-5104
Practice Address - Country:US
Practice Address - Phone:813-399-2128
Practice Address - Fax:727-245-8661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty