Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Aug 15, 2023
License(s)
9117729 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 9748 NW 126TH TER | Hialeah Gardens, FL 33018-7406 | 786-253-1824 |
| LOCATION | 8725 SW 136TH ST STE 120 | Miami, FL 33176-5814 | 786-595-1650 |
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