Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Apr 3, 2014
License(s)
103864 (GA), 0101284692 (VA), ME144379 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1475 NW 12TH AVE | Miami, FL 33136-1002 | 305-243-5512 |
| MAILING | 1475 NW 12TH AVE | Miami, FL 33136-1002 | 305-243-5512 |
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