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General NPI Number Information
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NPI Number | 1114412962
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Entity Type | Organization
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Legal Business Name | SEMINOLE CARE & REHAB CENTER, INC.
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 10875 PARK BLVD STE B1
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City | SEMINOLE
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State | FL
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Zip | 33772-5456
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Country | US
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Telephone | 727-256-2296
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Fax |
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Provider Business Mailing Address
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Address Line | 10875 PARK BLVD STE B1
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City | SEMINOLE
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State | FL
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Zip | 33772-5456
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Country | US
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Telephone | 727-256-2296
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANNIE L BULES
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Credential |
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Telephone | 813-514-7449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | HCC1132C
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License Number State | FL
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