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General NPI Number Information
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NPI Number | 1063652980
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Entity Type | Organization
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Legal Business Name | SIGNATURE HOME HEALTH SERVICES
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 11896 COLLINS CREEK DR
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City | JACKSONVILLE
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State | FL
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Zip | 32258-1244
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Country | US
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Telephone | 904-880-9717
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Fax | 904-880-9712
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Provider Business Mailing Address
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Address Line | 11896 COLLINS CREEK DR
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City | JACKSONVILLE
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State | FL
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Zip | 32258-1244
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Country | US
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Telephone | 904-880-9717
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Fax | 904-880-9712
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID MAFIE
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Credential | DPT
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Telephone | 904-880-9717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT24003
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License Number State | FL
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