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General NPI Number Information
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NPI Number | 1083178412
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Entity Type | Organization
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Legal Business Name | SPECIALTY CARE SERVICES INC
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Dates
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Enumeration Date | 01/30/2019
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 701 SE 43RD ST
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City | GAINESVILLE
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State | FL
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Zip | 32641-7665
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Country | US
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Telephone | 352-209-2431
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Fax | 215-559-6336
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Provider Business Mailing Address
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Address Line | PO BOX 483
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City | OCALA
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State | FL
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Zip | 34478-0483
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Country | US
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Telephone | 352-258-4015
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Fax | 215-559-6336
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Authorized Official
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Title or Position | DIRECTOR
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Name | EDWARD JEROME PORTER
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Credential | RN
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Telephone | 352-258-4015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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