MY PAIN DOCTOR
Medical Practice at 53 Ave, Gainesville, FL

License number
Florida ME107880
Category
Medical Practice
Type
Pain Medicine
Owner
Name: HECTOR MIRANDA-GRAJALES M.D.
Title: MEDICAL DIRECTOR
Phone: (855) 915-7246
Address
Address
4611 NW 53Rd Ave, Gainesville, FL 32653
National Provider ID: 1740612845
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MY PAIN DOCTOR, LLC

4611 NW 53 Ave, Gainesville, FL 32653

Industry:
Nonclassifiable Establishments
Registration:
Jul 17, 2013
State ID:
L13000101005
Business type:
Florida Limited Liability Company
Managers:
Miranda-Grajales, Hector A, 2337 SW Archer Rd APT 1058, Gainesville, FL 32608 (Physical),Hector A. Miranda-Grajales (Manager)
EIN:
46-3197066

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