Organization
NEW SERVICE PAIN LEJANDRO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEJANDRO RIVAS (PRESIDENT)
(305) 509-0602
Entity
Organization
Contact information
Practice address
224 DATURA ST, SUITE 200, WEST PALM BEACH, FL 33401-5624
(305) 509-0602
(305) 675-2668
Mailing address
224 DATURA ST, SUITE 200, WEST PALM BEACH, FL 33401-5624
(305) 509-0602
(305) 675-2668
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC7558
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC7558
AHCA LICENSE
FL
Enumeration date
03/19/2007
Last updated
08/22/2020
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