Healthcare Provider Details

I. General information

NPI: 1619827268
Provider Name (Legal Business Name): EKO LABS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 NW 115TH AVE
CORAL SPRINGS FL
33065-7264
US

IV. Provider business mailing address

3900 NW 115TH AVE
CORAL SPRINGS FL
33065-7264
US

V. Phone/Fax

Practice location:
  • Phone: 408-748-4101
  • Fax: 833-380-1599
Mailing address:
  • Phone: 408-748-4101
  • Fax: 833-380-1599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1835P1400X
TaxonomyPain Management Pharmacist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBIN GIBBS
Title or Position: CEOO
Credential:
Phone: 408-748-4101