Individual
FALLON LATRICE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5967 NW 21ST ST, LAUDERHILL, FL 33313-7604
(305) 924-3333
Mailing address
5967 NW 21ST ST, LAUDERHILL, FL 33313-7604
(305) 924-3333
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
G650252847490
FL
Other
Enumeration date
12/18/2018
Last updated
09/23/2019
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