Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 7, 2019
License(s)
PA9114869 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1508 BAY RD APT 219 | Miami Beach, FL 33139-3231 | 201-660-4327 |
| LOCATION | 1508 BAY RD APT 219 | Miami Beach, FL 33139-3231 | 201-660-4327 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.