Provider Demographics
NPI:1952621963
Name:PAIN MANAGEMENT OF TAMPA, LLC.
Entity Type:Organization
Organization Name:PAIN MANAGEMENT OF TAMPA, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREJS
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-936-9326
Mailing Address - Street 1:2901 W BUSCH BLVD
Mailing Address - Street 2:SUITE #807
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4523
Mailing Address - Country:US
Mailing Address - Phone:813-936-9326
Mailing Address - Fax:813-936-9327
Practice Address - Street 1:2901 W BUSCH BLVD
Practice Address - Street 2:SUITE #807
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4523
Practice Address - Country:US
Practice Address - Phone:813-936-9326
Practice Address - Fax:813-936-9327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMC371261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain