Provider First Line Business Practice Location Address:
DEPT OF PEDIATRIC CRITICAL CARE SHANDS
Provider Second Line Business Practice Location Address:
1600 SW ARCHER RD, STE. 10-504, BOX 100296
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32610-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-265-0462
Provider Business Practice Location Address Fax Number:
352-265-0443
Provider Enumeration Date:
08/24/2005