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NPI 1154786085

NPI 1154786085 : S &J THERAPY CENTER CORP : DORAL, FL

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General NPI Number Information
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    NPI Number           |    1154786085
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    Entity Type          |    Organization 
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    Legal Business Name  |    S &J THERAPY CENTER CORP 
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Dates
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    Enumeration Date     |    12/18/2015
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    Last Update Date     |    12/18/2015
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Provider Practice Location Address
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    Address Line         |    8180 NW 36TH ST SUITE 229
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    City                 |    DORAL
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    State                |    FL
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    Zip                  |    33166-6645
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    Country              |    US
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    Telephone            |    305-512-6008
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8180 NW 36TH ST SUITE 229
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    City                 |    DORAL
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    State                |    FL
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    Zip                  |    33166-6645
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    Country              |    US
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    Telephone            |    305-512-6008
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     SUSANA  LOPEZ 
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    Credential           |    
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    Telephone            |    305-512-6008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208D00000X
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    Taxonomy Name        |    General Practice Physician
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    License Number       |    
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    License Number State |    
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