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Individual

MR. HENRY JOSE PEDRIQUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MBA

Contact information

Practice address
6956 W SAMPLE RD, CORAL SPRINGS, FL 33067-4284
(954) 993-0874
Mailing address
6956 W SAMPLE RD, CORAL SPRINGS, FL 33067-4284
(954) 993-0874

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
P230513
FL

Other

Enumeration date
08/10/2014
Last updated
08/10/2014
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