Organization
ST JUDE PROFESSIONAL SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSVALDO PINEIRO SR. LMT (PRESIDENT)
(786) 360-1452
Entity
Organization
Contact information
Practice address
2387 W 68TH ST, 504, HIALEAH, FL 33016-6889
(786) 360-1452
(786) 360-1877
Mailing address
2387 W 68TH ST, 504, HIALEAH, FL 33016-6889
(786) 360-1452
(786) 360-1877
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
10256
FL
Other
Enumeration date
01/25/2012
Last updated
03/09/2012
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