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299 Alhambra Cir Ste 501

Coral Gables, FL 33134

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Hotel Reservation Request

Name and Last Name (of person checking in)

Name, email and phone number of the person making this reservation ( if different)

Email

Preferred Hotel

Check-in

Cell

Preferred Room Type

Check-out

Special Requirement

Name of credit card holder

Credit Card Name

Number of Credit Card

Valid Thru (mm/yy)

Security Code

Billing address

City

State

Zip Code

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