Provider First Line Business Practice Location Address:
JACKSON SOUTH MEDICAL CENTER
Provider Second Line Business Practice Location Address:
9333 SW 152 STREET
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33137-4495
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-256-5237
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2019