Provider First Line Business Practice Location Address:
3422 NW 187TH ST
Provider Second Line Business Practice Location Address:
HEALTH CLINIC
Provider Business Practice Location Address City Name:
MIAMI GARDENS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33056-2964
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-628-9556
Provider Business Practice Location Address Fax Number:
305-628-9493
Provider Enumeration Date:
06/24/2006