Registry details
Type
Individual
Primary specialty
Physician Assistant, Surgical
Enumerated
May 12, 2006
License(s)
PA9101874 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 8900 SW 117TH AVE SUITE B104 | Miami, FL 33186-2175 | 305-279-0159 |
| LOCATION | 8900 SW 117TH AVE SUITE B104 | Miami, FL 33186-2175 | 305-279-0159 |
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.