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General NPI Number Information
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NPI Number | 1194855494
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Entity Type | Organization
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Legal Business Name | MIAMI MEDICAL GROUP & HOLISTIC CARE INC.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4505 W FLAGLER ST SUITE 101
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City | MIAMI
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State | FL
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Zip | 33134-1500
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Country | US
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Telephone | 305-445-0048
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Fax | 305-569-0071
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Provider Business Mailing Address
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Address Line | 4505 W FLAGLER ST SUITE 101
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City | MIAMI
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State | FL
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Zip | 33134-1500
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Country | US
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Telephone | 305-445-0048
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Fax | 305-569-0071
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JUAN F. JIMENEZ
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Credential | AP DOM
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Telephone | 305-445-0048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number |
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License Number State |
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