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General NPI Number Information
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NPI Number | 1073945713
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Entity Type | Organization
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Legal Business Name | ODOROSOMI MEDICAL CENTER INC
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Dates
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Enumeration Date | 08/05/2013
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Last Update Date | 08/05/2013
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Provider Practice Location Address
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Address Line | 3300 E 4TH AVE STE 6
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City | HIALEAH
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State | FL
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Zip | 33013-3099
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Country | US
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Telephone | 305-362-2527
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Fax | 305-362-2530
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Provider Business Mailing Address
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Address Line | 3300 E 4TH AVE STE 6
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City | HIALEAH
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State | FL
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Zip | 33013-3099
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Country | US
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Telephone | 305-362-2527
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Fax | 305-362-2530
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Authorized Official
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Title or Position | PRESIDENT
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Name | REYES E LUIS
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Credential |
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Telephone | 305-362-2527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | FL
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