Provider First Line Business Practice Location Address:
3600 WASHINGTON STREET
Provider Second Line Business Practice Location Address:
MEMORIAL HOSPITAL SOUTH
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:
954-518-5351
Provider Business Practice Location Address Fax Number:
954-518-2213
Provider Enumeration Date:
10/03/2008