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1013934470
ANTONIO G REVILLA
FORT LAUDERDALE, FL
NPI
1013934470
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: FL ME21737)
Enumeration Date
2006-07-15
Last Update Date
2013-03-06
Business Address
-- ANTONIO G REVILLA MD
1880 E COMMERCIAL BLVD SUITE 3
FORT LAUDERDALE, FL 33308-3747
Phone number: 954-772-0949
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Mailing Address
-- ANTONIO G REVILLA MD
1880 E COMMERCIAL BLVD SUITE 3
FORT LAUDERDALE, FL 33308-3747
Phone number: 954-772-0949
Copy
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