Coral Ridge Professional Group LLC

NPI #1215284757 in Plantation, Florida

Provider Information

NPI Number
1215284757
Entity Type
Organization
Organization Name
Coral Ridge Professional Group LLC
Primary Specialty
Specialist
Enumeration Date
Aug 14, 2012
Last Updated
Aug 14, 2012

Practice Location

Address
9633 W BROWARD BLVD
Address 2
SUITE 6
State
Florida
ZIP Code
33324-2332
Phone
(561) 202-0834

Authorized Official

Name
TAMMY RODRIGUEZ
Title
BILLING MANAGER
Phone
(561) 202-0834

Specialties & Taxonomy Codes

Specialty
Specialist

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