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General NPI Number Information
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NPI Number | 1013105303
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALING OPTIONS, INC.
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 12251 TAFT ST 303
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-1901
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Country | US
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Telephone | 954-549-6580
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Fax | 954-322-1421
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Provider Business Mailing Address
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Address Line | 12251 TAFT ST 303
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-1901
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Country | US
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Telephone | 954-549-6580
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Fax | 954-322-1421
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOUIS LAFIELD PACHECO
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Credential | A.P., D.O.M.
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Telephone | 954-549-6580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | AP1515
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | AP1515
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License Number State | FL
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