NPI | 1093695504 |
---|---|
Entity Type | Organization |
Authorized Contact | PHAEDRA L SHUDRA Credentialing And Contracting Speci 813-785-4861 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Additional Taxonomies | 207L00000X Anesthesiology |
207RH0002X Internal Medicine, Hospice and Palliative Medicine | |
207LP2900X Anesthesiology, Pain Medicine | |
208VP0000X | |
208100000X Physical Medicine & Rehabilitation | |
Enumeration Date | 2025-09-04 |
Last Update Date | 2025-09-26 |