Provider First Line Business Practice Location Address:
KROME SERVICE PROCESSING CENTER
Provider Second Line Business Practice Location Address:
18201 SW 12TH STREET
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33194
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-207-2001
Provider Business Practice Location Address Fax Number:
928-338-3510
Provider Enumeration Date:
09/10/2010