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NPI 1225288269

NPI 1225288269 : FIRST GOLDEN SERVICES INC : VIRGINIA GARDENS, FL

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General NPI Number Information
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    NPI Number           |    1225288269
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    Entity Type          |    Organization 
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    Legal Business Name  |    FIRST GOLDEN SERVICES INC 
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Dates
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    Enumeration Date     |    09/26/2008
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    Last Update Date     |    09/26/2008
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Provider Practice Location Address
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    Address Line         |    6595 NW 36TH ST SUITE C 320 C
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    City                 |    VIRGINIA GARDENS
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    State                |    FL
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    Zip                  |    33166-6979
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    Country              |    US
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    Telephone            |    305-871-0777
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    Fax                  |    305-871-0999
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Provider Business Mailing Address
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    Address Line         |    6595 NW 36TH ST SUITE C 320 C
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    City                 |    VIRGINIA GARDENS
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    State                |    FL
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    Zip                  |    33166-6979
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    Country              |    US
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    Telephone            |    305-871-0777
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    Fax                  |    305-871-0999
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MR. LIRIO  PADRON 
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    Credential           |    
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    Telephone            |    305-871-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    302F00000X
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    Taxonomy Name        |    Exclusive Provider Organization
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    License Number       |    
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    License Number State |    
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