Graduated: 2021
NPI: 1962190769
Practice Locations (3)
1120 BAYVIEW DR
FORT LAUDERDALE, FL 333042505
1120 BAYVIEW DR
FORT LAUDERDALE, FL 333042552
201 S FEDERAL HWY, APT 3008
FORT LAUDERDALE, FL 333014604
Source: CMS National Downloadable File, September 2026.