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General NPI Number Information
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NPI Number | 1023398310
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Entity Type | Organization
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Legal Business Name | ZION HEALTH CARE LLC
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Dates
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Enumeration Date | 08/18/2011
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 2100 W 76TH ST FL 5
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City | HIALEAH
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State | FL
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Zip | 33016-5539
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Country | US
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Telephone | 786-536-9719
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Fax | 786-536-9847
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Provider Business Mailing Address
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Address Line | 1470 N.W. 107 AVE SUITE G
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City | MIAMI
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State | FL
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Zip | 33172
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Country | US
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Telephone | 786-536-9719
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Fax | 786-536-9847
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | JULIETTA MARRERO
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Credential | LMHC
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Telephone | 786-536-9719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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