Individual
NGA LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
3600 WASHINGTON ST, HOLLYWOOD, FL 33021-8216
(855) 367-3650
Mailing address
12008 SW 47TH ST, COOPER CITY, FL 33330-4008
(954) 296-5256
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
FL
Other
Enumeration date
09/13/2015
Last updated
03/30/2021
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