Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Nov 15, 2005
License(s)
ME45736 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 10000 BAY PINES BLVD. BLDG 100, RM 1E-203 BAY PINES VAHCS | Bay Pines, FL 33744 | 727-398-6661 |
| MAILING | 10000 BAY PINES BLVD. (SURGICAL SERVICES 112) BAY PINES VAHCS | Bay Pines, FL 33744 | 727-398-6661 |
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