AvMedQuotes.com 3585 NE 207th St #800347 Aventura, FL 33180 (305) 933-2282 First Name (required) Last Name (required) Email Address (required) Phone Number (required) Zip Code (required) Date of Birth (required) YesNo Smoker? [radio* smoker id:smoker class:smoker label_first default:1 "Yes" "No"] Number of Dependents: ---0123456 Questions or Comments