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Organization

SOUTH LAKE PAIN INSTITUTE, INC

Active
Other names
South Lake Pain Institute, PA, South Lake Pain Institute, Inc
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SAMILDRE PACHECO (PRACTICE ADMINISTRATOR)
(352) 394-0833
Entity
Organization

Contact information

Practice address
2440 HOOKS STREET, CLERMONT, FL 34711
(352) 394-0833
(352) 394-0367
Mailing address
2440 HOOKS STREET, CLERMONT, FL 34711
(352) 394-0833
(352) 394-0367

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
OS8836
FL
174400000X
Specialist
Primary
FL

Other

Enumeration date
08/13/2006
Last updated
10/08/2019
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