NPI 1215284757

Coral Ridge Professional Group LLC

Organisation Specialist Plantation, FL

Practice location

Address: 9633 W Broward Blvd Suite 6, Plantation, FL 33324-2332
Phone: (561) 202-0834

Authorised official

Name: Tammy Rodriguez
Title: Billing Manager
Phone: (561) 202-0834

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

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Registry record

NPI: 1215284757
Entity type: Organization
NPI issued: 14 Aug 2012
Record last updated: 14 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.