Organization Active NPI

Pain Care Management of Tampa, LLC

  • Pain Clinic/Center
  • Tampa, FL
National Provider Identifier
1639489776
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
PMC268 Issued in FL
Legal business name
PAIN CARE MANAGEMENT OF TAMPA, LLC
Practice address
1121 Marbella Plaza Dr
Tampa, FL 33619-7905
Phone
(813) 571-3233
Fax
(813) 630-5875
NPI assigned
Oct 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Authorized official

Name
Mr. C R Long
Title
Managing Member
Phone
(321) 251-4462

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X PMC268 FL Primary

Addresses

Primary practice location

1121 Marbella Plaza Dr
Tampa, FL 33619-7905

Mailing address

5036 Dr Phillips Blvd
Suite 337
Orlando, FL 32819-3310
Phone (321) 251-4462

Other names 1

  • Pain Care Plus Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1639489776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 DR PHILLIPS BLVD",
            "address_2": "SUITE 337",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328193310",
            "telephone_number": "321-251-4462",
            "fax_number": "888-469-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 MARBELLA PLAZA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197905",
            "telephone_number": "813-571-3233",
            "fax_number": "813-630-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE MANAGEMENT OF TAMPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-07",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "321-251-4462",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "FL",
            "license": "PMC268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Care Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.