Provider Demographics
NPI:1770975609
Name:CENTER FOR INTERVENTIONAL PAIN MANAGEMENT
Entity type:Organization
Organization Name:CENTER FOR INTERVENTIONAL PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIDEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-552-3488
Mailing Address - Street 1:1501 LAUREL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-7039
Mailing Address - Country:US
Mailing Address - Phone:941-552-3488
Mailing Address - Fax:941-552-3486
Practice Address - Street 1:1501 LAUREL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7039
Practice Address - Country:US
Practice Address - Phone:941-552-3488
Practice Address - Fax:941-552-3486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87545174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty