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General NPI Number Information
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NPI Number | 1184074379
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Entity Type | Organization
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Legal Business Name | CARE CENTERED LLC
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 5850 CORAL RIDGE DR SUITE 302
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-3378
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Country | US
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Telephone | 877-639-3613
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Fax |
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Provider Business Mailing Address
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Address Line | 5850 CORAL RIDGE DR SUITE 302
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-3378
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Country | US
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Telephone | 877-639-3613
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. STEVEN FRANCIS LICA
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Credential |
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Telephone | 954-854-6756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 78028
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License Number State | FL
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