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1356987721
POOJA PRAKASH BAVISKAR
DAVIE, FL
NPI
1356987721
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: FL 9112760)
Enumeration Date
2019-11-20
Last Update Date
2020-01-02
Business Address
POOJA PRAKASH BAVISKAR
931 SW 111TH WAY
DAVIE, FL 33324-4130
Phone number: 954-608-3790
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Mailing Address
POOJA PRAKASH BAVISKAR
931 SW 111TH WAY
DAVIE, FL 33324-4130
Phone number:
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