Organization
SOURCE OF LIFE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PEDRO SANCHEZ MA (PRESIDENT)
(786) 344-3001
Entity
Organization
Contact information
Practice address
5500 SW 77TH CT APT 301, MIAMI, FL 33155-4375
(786) 344-1998
Mailing address
4011 W FLAGLER ST STE 301, CORAL GABLES, FL 33134-1643
(305) 644-2800
(305) 644-2101
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
MA59149
FL
Other
Enumeration date
11/19/2010
Last updated
11/19/2010
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