Provider First Line Business Practice Location Address:
MIAMI LIGHTHOUSE
Provider Second Line Business Practice Location Address:
601 SOUTHWEST 8TH AVENUE
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-856-2288
Provider Business Practice Location Address Fax Number:
305-285-6967
Provider Enumeration Date:
10/23/2009