Provider First Line Business Practice Location Address:
11901 SW 2ND ST
Provider Second Line Business Practice Location Address:
MARJORY STONEMAN DOUGLAS ELEMENTARY
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33184-1601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-576-6611
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/25/2010