Provider First Line Business Practice Location Address:
1611 NW 12 AVENUE
Provider Second Line Business Practice Location Address:
REHAB BLDG 303
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-585-1111
Provider Business Practice Location Address Fax Number:
305-571-0634
Provider Enumeration Date:
04/13/2006