LA CLINIQUE 300 INC
Ambulatory Health at Andrews Ave, Fort Lauderdale, FL

License number
Florida ME43065
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: DR. JOSEPH FANFAN MD
Title: PRESIDENT
Phone: (954) 525-4900
Address
Address
2630 N Andrews Ave, Fort Lauderdale, FL 33311
National Provider ID: 1689059453
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LA CLINIQUE 300, INC

2630 N Andrews Ave, Fort Lauderdale, FL 33311

Registration:
Jul 1, 2015
State ID:
P15000056939
Business type:
Florida Profit Corporation
S:
Md Fanfan, 2630 N Andrews Ave, Fort Lauderdale, FL 33311 (Physical),Ketlyne Fanfan, 2630 N Andrews Ave, Fort Lauderdale, FL 33311 (Physical),Fanfan, Joseph, Jr, 2630 N Andrews Ave, Fort Lauderdale, FL 33311 (Physical)
FEI/EIN:
65-0167934

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