Individual
GUERLANDE MOMPREMIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3211 SW 66TH AVE, MIRAMAR, FL 33023-3867
(954) 512-7624
Mailing address
3211 SW 66TH AVE, MIRAMAR, FL 33023-3867
(954) 512-7624
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA59700
FL
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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