Organization
PAIN SPECIALISTS OF MIAMI LAKES CORP
Active
Other names
TREE OF LYFE SPORTS MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
PABLO SMITH (AUTHORIZED OFFICIAL)
(786) 562-0632
Entity
Organization
Contact information
Practice address
15600 NW 67TH AVE STE 203, MIAMI LAKES, FL 33014-2175
(786) 365-1492
(305) 397-2963
Mailing address
15600 NW 67TH AVE STE 203, MIAMI LAKES, FL 33014-2175
(786) 365-1492
(305) 397-2963
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
213E00000X
Podiatrist
—
—
213ES0000X
Sports Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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