Organization
WILMAR MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILL INNOCENT M.D. (OFFICER)
(561) 290-4144
Entity
Organization
Contact information
Practice address
4849 LAKE WORTH RD, GREENACRES, FL 33463-3455
(561) 290-4144
Mailing address
PO BOX 221313, WEST PALM BEACH, FL 33422-1313
(561) 290-4144
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ME92937
FL
261Q00000X
Clinic/Center
ME93404
FL
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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