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General NPI Number Information
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NPI Number | 1144901240
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 4700 MILLENIA BLVD STE 500
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City | ORLANDO
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State | FL
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Zip | 32839-6019
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Country | US
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Telephone | 787-464-2592
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Fax |
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Provider Business Mailing Address
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Address Line | 701 PETES LN
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City | DAVENPORT
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State | FL
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Zip | 33837-8762
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Country | US
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Telephone | 787-464-2592
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LUIS COLON MARQUEZ
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Credential | MH 20962
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Telephone | 787-464-2592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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