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1962962316
SOUTHEAST WELLNESS LANE CORP
DAVIE, FL
NPI
1962962316
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Entity Type
Organization
Authorized Contact
YURI SALAS ESPINOSA
President
786-493-2293
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
Enumeration Date
2019-03-21
Last Update Date
2019-03-21
Business Address
SOUTHEAST WELLNESS LANE CORP
13265 SW 39TH ST
DAVIE, FL 33330-4748
Phone number: 786-493-2293
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Mailing Address
SOUTHEAST WELLNESS LANE CORP
13265 SW 39TH ST
DAVIE, FL 33330-4748
Phone number: 786-493-2293
Copy
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