Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 17, 2014
License(s)
PA9108340 (FL), PA9108340 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3000 NE 57TH ST | Fort Lauderdale, FL 33308-2810 | 954-648-7948 |
| MAILING | 3000 NE 57TH ST | Fort Lauderdale, FL 33308-2810 |
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