Sunlake Pain Management, LLC

NPI #1114153483 in Lutz, Florida

Provider Information

NPI Number: 1114153483
Entity Type: Organization
Organization Name: Sunlake Pain Management, LLC
Primary Specialty: Clinic/Center
Enumeration Date: Jun 1, 2009
Last Updated: Apr 1, 2010

Practice Location

Address: 18964 DALE MABRY HWY N
Address 2: STE 101
City: Lutz
State: Florida
ZIP Code: 33548-4913
Phone: (813) 948-2107

Authorized Official

Name: DR. LUIS A. LOGRONO, MD
Title: MEDICAL DIRECTOR
Phone: (813) 948-2107

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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