Provider First Line Business Practice Location Address:
780 SW 24TH ST
Provider Second Line Business Practice Location Address:
MEDICAL ADMINSTRATION
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33315-2643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-467-4822
Provider Business Practice Location Address Fax Number:
954-760-7798
Provider Enumeration Date:
11/10/2008