Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Feb 13, 2008
License(s)
5101015859 (MI), OS 10611 (FL), OS10611 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 160 NW 170TH ST | North Miami Beach, FL 33169-5521 | 305-651-1100 |
| MAILING | 4581 WESTON ROAD BOX 327 | Weston, FL 33331-3141 | 305-654-5221 |
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