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General NPI Number Information
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NPI Number | 1104870856
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Entity Type | Organization
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Legal Business Name | PHYSICIANS CARE PLUC INC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9750 NW 33RD ST 214
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4042
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Country | US
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Telephone | 954-510-8200
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Fax | 954-510-0474
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Provider Business Mailing Address
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Address Line | 7800 W OAKLAND PARK BLVD E214
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City | SUNRISE
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State | FL
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Zip | 33351-6741
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Country | US
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Telephone | 954-510-8200
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Fax | 954-510-0474
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MANUAL GONZALEZ
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Credential | MD
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Telephone | 954-510-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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