Provider First Line Business Practice Location Address:
653-1 W 8TH ST
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PEDIATRIC UNIVERSITY OF FLORIDA
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32209-6511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-244-3027
Provider Business Practice Location Address Fax Number:
904-244-3028
Provider Enumeration Date:
10/18/2005