South Lake Pain Institute, INC

NPI #1033121546 in Clermont, Florida

Provider Information

NPI Number: 1033121546
Entity Type: Organization
Organization Name: South Lake Pain Institute, INC
Primary Specialty: Specialist
Enumeration Date: Aug 13, 2006
Last Updated: Oct 8, 2019

Practice Location

Address: 2440 HOOKS STREET
City: Clermont
State: Florida
ZIP Code: 34711
Phone: (352) 394-0833

Authorized Official

Name: MRS. SAMILDRE PACHECO
Title: PRACTICE ADMINISTRATOR
Phone: (352) 394-0833

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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