Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 14, 2013
License(s)
ME121391 (FL), ME121391 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 52 W UNDERWOOD ST | Orlando, FL 32806-1110 | 321-842-8475 |
| MAILING | 52 UNDERWOOD ST MP 153 | Orlando, FL 32806-1110 | 321-841-2558 |
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