Provider First Line Business Practice Location Address:
13020 PARK BLVD
Provider Second Line Business Practice Location Address:
OAKHURST MEDICAL CLINIC
Provider Business Practice Location Address City Name:
SEMINOLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33776-3639
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-393-3404
Provider Business Practice Location Address Fax Number:
727-393-4814
Provider Enumeration Date:
07/10/2006