Organization
MEDEBRA INC
Active
Other names
medebra inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM PAUCEK HALEY (OWNER)
(954) 763-9479
Entity
Organization
Contact information
Practice address
2530 OKEECHOBEE LN, FT LAUDERDALE, FL 33312-4624
(954) 763-9479
(954) 712-2289
Mailing address
2530 OKEECHOBEE LN, FT LAUDERDALE, FL 33312-4624
(954) 763-9479
(954) 712-2289
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
08/16/2010
Last updated
08/16/2010
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