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General NPI Number Information
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NPI Number | 1023361565
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Entity Type | Organization
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Legal Business Name | INFUSION CENTER OF SOUTH FLORIDA, LLC
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 1626 COLE BLVD SUITE 100
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City | LAKEWOOD
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State | CO
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Zip | 80401-3306
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Country | US
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Telephone | 303-384-4051
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Fax | 720-497-9751
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Provider Business Mailing Address
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Address Line | 4000 HOLLYWOOD BLVD 555-S
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6751
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Country | US
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Telephone | 303-384-4051
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Fax | 720-497-9751
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MICHAEL P GLINSKY
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Credential |
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Telephone | 303-384-4155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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