Registry details
Type
Individual
Primary specialty
Family Medicine
Enumerated
Feb 14, 2013
License(s)
OS12121 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 39200 HOOKER HWY | Belle Glade, FL 33430-5368 | 561-996-6571 |
| MAILING | 3907 S JOG RD | Greenacres, FL 33467-1590 |
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.