Provider First Line Business Practice Location Address:
4015 PRIMARY PEMBROKE ROAD
Provider Second Line Business Practice Location Address:
MEMORIAL PRIMARY CARE CENTER
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-987-1551
Provider Business Practice Location Address Fax Number:
954-752-8214
Provider Enumeration Date:
09/06/2006