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General NPI Number Information
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NPI Number | 1205408945
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Entity Type | Organization
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Legal Business Name | HEARTILY TOUCH, LLC
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 11314 SAGE CANYON DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-9318
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Country | US
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Telephone | 813-841-6404
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Fax |
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Provider Business Mailing Address
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Address Line | 11314 SAGE CANYON DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-9318
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Country | US
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Telephone | 813-841-6404
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ENIOLA AGBEDE
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Credential |
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Telephone | 813-841-6404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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