Provider First Line Business Practice Location Address:
1601 E LAS OLAS BLVD
Provider Second Line Business Practice Location Address:
FORT LAUDERDALE HOSPITAL
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33301-2357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-453-8651
Provider Business Practice Location Address Fax Number:
954-525-2584
Provider Enumeration Date:
01/28/2009