Provider First Line Business Practice Location Address:
3501 JOHNSON ST
Provider Second Line Business Practice Location Address:
DIVISION OF PEDIATRICS, INPATIENT
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-457-8771
Provider Business Practice Location Address Fax Number:
954-241-6908
Provider Enumeration Date:
09/21/2005