Provider First Line Business Practice Location Address:
5757 NORTH DIXIE HIGHWAY
Provider Second Line Business Practice Location Address:
C/O NORTH RIDGE MEDICAL CENTER
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-776-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/23/2006