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General NPI Number Information
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NPI Number | 1184523466
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Entity Type | Organization
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Legal Business Name | OMERTA MEDICAL CENTER CORP
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 11300 NW 87TH CT STE 149
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4520
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Country | US
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Telephone | 305-339-3011
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Fax | 855-700-5308
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Provider Business Mailing Address
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Address Line | 11300 NW 87TH CT STE 149
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4520
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Country | US
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Telephone | 305-339-3011
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Fax | 855-700-5308
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Authorized Official
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Title or Position | OWNER
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Name | LUIS LEDESMA
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Credential |
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Telephone | 305-218-4018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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