Organization
LICE CLINICS OF AMERICA DADE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EDITH IBANEZ (OWNER)
(786) 239-6645
Entity
Organization
Contact information
Practice address
175 FONTAINEBLEAU BLVD STE 1H, MIAMI, FL 33172-7012
(786) 239-6645
Mailing address
175 FONTAINEBLEAU BLVD STE 1H, MIAMI, FL 33172-7012
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
—
—
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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