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General NPI Number Information
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NPI Number | 1144459900
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Entity Type | Organization
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Legal Business Name | COMPLETE THERAPY CENTER
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 352 NW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33125-3031
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Country | US
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Telephone | 305-646-6711
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Fax | 305-646-6712
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Provider Business Mailing Address
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Address Line | 352 NW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33125-3031
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Country | US
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Telephone | 305-646-6711
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Fax | 305-646-6712
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Authorized Official
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Title or Position | OWNER
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Name | MR. EMERSON RUIZ ECHEVARRIA
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Credential |
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Telephone | 786-474-8564
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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 | MM23361
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | CH8101
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License Number State | FL
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