Provider First Line Business Practice Location Address:
6401 N FEDERAL HWY
Provider Second Line Business Practice Location Address:
IMPERIAL POINT MEDICAL CENTER
Provider Business Practice Location Address City Name:
FT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33308-1405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-485-5666
Provider Business Practice Location Address Fax Number:
954-484-1651
Provider Enumeration Date:
10/12/2005