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General NPI Number Information
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NPI Number | 1164807566
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Entity Type | Organization
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Legal Business Name | MAXIMUM PHYSICAL HEALTHCARE LLC
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 1915 EASTWEST PKWY SUITE 2
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-6404
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Country | US
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Telephone | 904-269-1799
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Fax | 904-269-0970
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Provider Business Mailing Address
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Address Line | 1915 EAST WEST PARKWAY SUITE 2
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City | FLEMING ISLAND
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State | FL
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Zip | 32003
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Country | US
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Telephone | 904-269-1799
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Fax | 904-269-0970
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH MUSA
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Credential |
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Telephone | 904-269-1799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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