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General NPI Number Information
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NPI Number | 1184335069
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Entity Type | Organization
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Legal Business Name | REWIRED THERAPY LLC
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Dates
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Enumeration Date | 12/12/2022
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 12550 BISCAYNE BLVD STE 304
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2537
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Country | US
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Telephone | 305-397-8623
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 NE 214TH ST STE 1002
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City | AVENTURA
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State | FL
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Zip | 33180-1270
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Country | US
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Telephone | 305-626-6070
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | DR. JACOB SILVERSTONE
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Credential | DPM
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Telephone | 305-676-6070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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