Saint Petersburg Interventional Pain Management LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

ME85040 Issued in FL

Legal business name

SAINT PETERSBURG INTERVENTIONAL PAIN MANAGEMENT LLC

Practice address

620 10TH St N
Suite 2D
St Petersburg, FL 33705-1407

Phone

(727) 824-8383

NPI assigned

Dec 10, 2015

Last updated

Dec 10, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Danya Alida Godoy, M.D.

Title

Doctor

Phone

(172) 714-8573

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1306211743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 10TH ST NORTH",
            "address_2": "2D",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "33704",
            "telephone_number": "727-824-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 10TH ST N",
            "address_2": "SUITE 2D",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051407",
            "telephone_number": "727-824-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT PETERSBURG INTERVENTIONAL PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "GODOY",
        "authorized_official_first_name": "DANYA",
        "authorized_official_middle_name": "ALIDA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "172-714-8573",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME85040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269485900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Saint Petersburg SNF LLC (Bayside Rehabilitaiton and Health Center)
• Saira Psychology LLC
• Imran Sajan, MD

• Pain Medicine Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.