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1588402044
BLUEGRASS ID ASSOCIATED LLC
WELLINGTON, FL
NPI
1588402044
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Entity Type
Organization
Authorized Contact
GAZALA KHAN
Manager
714-944-8105
Organization Subpart ?
No
Primary Taxonomy
207RI0200X Internal Medicine, Infectious Disease
Enumeration Date
2024-07-18
Last Update Date
2024-07-18
Business Address
BLUEGRASS ID ASSOCIATED LLC
BLUEGRASS ID ASSOCIATED LLC 1848 FOX CT
WELLINGTON, FL 33414
Phone number: 714-944-8105
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Mailing Address
BLUEGRASS ID ASSOCIATED LLC
BLUEGRASS ID ASSOCIATES LLC 1848 FOX CT
WELLINGTON, FL 33414
Phone number:
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