Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2022-11-15
- Last updated
- 2022-11-15
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 3350 SW 148TH AVE STE 110
- City
- MIRAMAR FL
- Postal code
- 330273237
- Phone
- 833-437-3484
Organization contact
- Name
- ALECIA BRYAN
- Title
- Director
- Phone
- 9173286220
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.