Provider First Line Business Practice Location Address:
1055 SAXON BLVD.,
Provider Second Line Business Practice Location Address:
FLORIDA HOSPITAL FISH MEMORIAL
Provider Business Practice Location Address City Name:
ORANGE CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32763
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-917-5434
Provider Business Practice Location Address Fax Number:
386-917-5101
Provider Enumeration Date:
06/05/2006