Provider Information for 1699955500
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Ms. ELIDA M SEGRERA M. S.
Sex: Female
NPI: 1699955500
Last Updated: 2011-01-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1699955500 | ||||||||
| Enumeration Date | 2007-11-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 351 N. STATE ROAD 7 SUITE 200 PLANTATION, FL 33317-2859 United States Phone: 954-327-4069 | Fax:954-792-9122 | ||||||||
| Primary Practice Address | 351 N. STATE ROAD 7 SUITE 200 PLANTATION, FL 33317-2859 United States Phone: 954-327-4069 | Fax:954-792-9122 | ||||||||
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