SOUTHEAST WELLNESS LANE CORP

DAVIE, FL
NPI1962962316
Entity TypeOrganization
Authorized ContactYURI SALAS ESPINOSA
President
786-493-2293
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
Enumeration Date2019-03-21
Last Update Date2019-03-21
Business Address
SOUTHEAST WELLNESS LANE CORP
13265 SW 39TH ST
DAVIE, FL 33330-4748
Phone number: 786-493-2293
Mailing Address
SOUTHEAST WELLNESS LANE CORP
13265 SW 39TH ST
DAVIE, FL 33330-4748
Phone number: 786-493-2293
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