Provider First Line Business Practice Location Address:
14750 NW 44 CT
Provider Second Line Business Practice Location Address:
USCG AIR STATION MIAMI MEDICAL FACIL
Provider Business Practice Location Address City Name:
OPA-LOCKA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-953-2369
Provider Business Practice Location Address Fax Number:
305-953-2308
Provider Enumeration Date:
12/27/2005