Organization
SERVICE PAIN HEALING LABRA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSVALDO LABRADOR LOPEZ (PRESIDENT)
(561) 584-0316
Entity
Organization
Contact information
Practice address
230 S DIXIE HWY, SUITE 102, LAKE WORTH, FL 33460-4154
(561) 584-0315
(305) 675-2668
Mailing address
230 S DIXIE HWY, SUITE 102, LAKE WORTH, FL 33460-4154
(561) 584-0315
(305) 675-2668
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC7523
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC7523
AHCA
FL
Enumeration date
02/22/2007
Last updated
08/22/2020
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