Organization
HEAVEN ON EARTH HEALTHY LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAOLA MENDOZA (CFO)
(407) 222-3069
Entity
Organization
Contact information
Practice address
305 N LAKEMONT AVE, 305 N. LAKEMONT AVE, WINTER PARK, FL 32792-3204
(407) 222-3069
Mailing address
305 N LAKEMONT AVE, 305 N. LAKEMONT AVE, WINTER PARK, FL 32792-3204
(407) 222-3069
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
MA 50907
FL
Other
Enumeration date
04/20/2011
Last updated
04/20/2011
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