Provider First Line Business Practice Location Address:
3511 NW 91ST AVENUE
Provider Second Line Business Practice Location Address:
US SOUTHERN COMMAND HEALTH CLINIC
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-437-1148
Provider Business Practice Location Address Fax Number:
305-224-6263
Provider Enumeration Date:
12/15/2006