Graduated: 2020
NPI: 1871110171
Practice Locations (4)
5950 W OAKLAND PARK BLVD, SUITE 300
LAUDERHILL, FL 333131260
2103 RENAISSANCE BLVD, APT 107
MIRAMAR, FL 330255691
3129 S CONGRESS AVE
PALM SPRINGS, FL 334612551
PO BOX
CHICAGO, IL 60673
Source: CMS National Downloadable File, September 2026.