Provider First Line Business Practice Location Address:
C/O FLORIDA MEDICAL CENTER
Provider Second Line Business Practice Location Address:
5000 WEST OAKLAND PARK BLVD
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-735-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2006