Healthcare Provider Details

I. General information

NPI: 1093137663
Provider Name (Legal Business Name): DR LAFFERS PAIN RELIEF CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 01/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257A COMMERCIAL BLVD
LAUDERDALE BY THE SEA FL
33308-4442
US

IV. Provider business mailing address

257A COMMERCIAL BLVD
LAUDERDALE BY THE SEA FL
33308-4442
US

V. Phone/Fax

Practice location:
  • Phone: 954-783-2025
  • Fax:
Mailing address:
  • Phone: 954-783-2025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL LAFFER
Title or Position: OWNER/PRESIDENT
Credential: A.P., O.M.D.
Phone: 954-783-2025