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1205378940
MATTHEW LEE ISLAM
LAKE WORTH, FL
NPI
1205378940
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
284300000X Special Hospital
Enumeration Date
2016-11-11
Last Update Date
2016-11-11
Business Address
-- MATTHEW LEE ISLAM
1733 3RD AVE N APT 11
LAKE WORTH, FL 33460-3286
Phone number: 561-312-9012
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Mailing Address
-- MATTHEW LEE ISLAM
1733 3RD AVE N APT 11
LAKE WORTH, FL 33460-3286
Phone number: 561-312-9012
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