CHARLES BROCK (NPI# 1871516021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871516021 |
| Entity Type | Individual |
| Full Name | CHARLES BROCK |
| Credential | MD |
| Practice Address |
12901 Bruce B Downs Blvd Tampa FL 33612-4742 |
| Mailing Address |
Po Box 917770 Orlando FL 32891-7770 |
| Practice Telephone | 8139740518 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
ME69227 | FL | Allopathic & Osteopathic Physicians |
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
ME069227 | FL | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
ME069227 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 254486500 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | 43672 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386747483 | Charles A Brock | Optometrist | 790 Montgomery Hwy Ste 110, Vestavia Hills, AL 35216-1873 | 2006-09-06 |
| 1245697069 | Charles Brock | Counselor | 8325 Kelwood Ave, Baton Rouge, LA 70806-4804 | 2016-01-25 |
| 1689761280 | Charles E Brock Jr. | Family Medicine | 810 E Sunflower Rd, Cleveland, MS 38732-2800 | 2006-10-06 |
| Street Address |
12901 BRUCE B DOWNS BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33612-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629076799 | Gonzalo Mantilla | Pediatrics | 12901 Bruce B Downs Blvd, Mdc 15, Tampa, FL 33612-4742 | 2005-07-12 |
| 1538796784 | Samia Valeria Ozorio Dutra | Registered Nurse | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2020-03-26 |
| 1255966289 | Jessica Huang | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2020-03-10 |
| 1487218764 | Chelsea Gebs Black | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612-4742 | 2019-04-23 |
| 1609430925 | Kathryn Elizabeth Rudibaugh | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-23 |
| 1467015883 | Thomas Cole | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2019-04-22 |
| 1417510751 | Kelly Powell | Physician Assistant | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-22 |
| 1700347283 | Kristopher Johnson | Nurse Practitioner | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4799 | 2019-03-27 |
| 1366909129 | Derrik Jose Diaz Navarro | Specialist/Technologist | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2019-02-27 |
| 1346717717 | Kyle William Woodward | Specialist/Technologist | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4799 | 2018-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285945147 | Tampa Total Health LLC | Pain Medicine | 3824 W Sligh Ave, Tampa, FL 33614-3961 | 2010-06-25 |
| 1144216433 | North Tampa Anesthesia Consultants | Pain Medicine | 1402 W Fletcher Ave, Tampa, FL 33612-3368 | 2005-09-22 |
| 1093190449 | Pain Institute of Tampa Bay, Plc | Pain Medicine | 15303 Amberly Dr Ste A, Tampa, FL 33647-2308 | 2015-07-28 |
| 1689078602 | Compassion Care LLC | Pain Medicine | 4816 N Armenia Ave, Tampa, FL 33603-1400 | 2014-10-20 |
| 1184051708 | Tampa Pain Management LLC | Pain Medicine | 4910 N Armenia Ave, Tampa, FL 33603-1402 | 2013-09-27 |
| 1457671554 | Padgett Medical Center, LLC | Pain Medicine | 6904 W Linebaugh Ave, Tampa, FL 33625-5800 | 2010-06-11 |
| 1215264478 | Gulf-to-bay Anesthesiology Associates LLC | Pain Medicine | 3000 E Fletcher Ave, Suite 205, Tampa, FL 33613-4656 | 2009-11-09 |
| 1689777617 | Vipul V Kabaria Md Pa | Pain Medicine | 13910 N Dale Mabry Hwy, Bldg 4, Ste 1, Tampa, FL 33618-2440 | 2006-09-06 |
| 1750399200 | Tampa Pain Clinic LLC | Pain Medicine | 3500 E Fletcher Ave, Room 204, Tampa, FL 33613-4708 | 2006-08-03 |
| 1720039746 | Gulf-to-bay Anesthesiology Associates LLC | Pain Medicine | 1 Tampa General Cir, Suite A327, Tampa, FL 33606-3571 | 2006-05-15 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.