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General NPI Number Information
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NPI Number | 1053764001
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Entity Type | Organization
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Legal Business Name | INJURY CENTRAL REHAB
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 1584 CITRUS MEDICAL CT
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City | OCOEE
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State | FL
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Zip | 34761-4547
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Country | US
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Telephone | 407-203-2190
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Fax |
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Provider Business Mailing Address
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Address Line | 11564 MIZZON DR UNIT 926
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City | WINDERMERE
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State | FL
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Zip | 34786-5554
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Country | US
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Telephone | 386-898-6783
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. HECTOR RAMOS MENDEZ
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Credential | DC
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Telephone | 386-898-6783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | CH10745
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH10745
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License Number State | FL
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