| Entity Name: | SERVICE PAIN HEALING LABRA INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Dec 2006 (18 years ago) |
| Date of dissolution: | 14 Sep 2007 (17 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 14 Sep 2007 (17 years ago) |
| Document Number: | P06000149892 |
| Address: | 230 SOUTH DIXIE HWY SUITE 102, LAKE WORTH, FL, 33460 |
| Mail Address: | 230 SOUTH DIXIE HWY SUITE 102, LAKE WORTH, FL, 33460 |
| ZIP code: | 33460 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417082454 | 2007-02-22 | 2020-08-22 | 230 S DIXIE HWY, SUITE 102, LAKE WORTH, FL, 334604154, US | 230 S DIXIE HWY, SUITE 102, LAKE WORTH, FL, 334604154, US | |||||||||||||||||||||||||
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| Phone | +1 561-584-0315 |
| Fax | 3056752668 |
Authorized person
| Name | MR. OSVALDO LABRADOR LOPEZ |
| Role | PRESIDENT |
| Phone | 5615840316 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | HCC7523 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA |
| Number | HCC7523 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LOPEZ OSVALDO L | Agent | 230 SOUTH DIXIE HWY SUITE 102, LAKE WORTH, FL, 33460 |
| Name | Role | Address |
|---|---|---|
| LOPEZ OSVALDO L | President | 230 SOUTH DIXIE HWY SUITE 102, LAKE WORTH, FL, 33460 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2006-12-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
