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General NPI Number Information
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NPI Number | 1235156910
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Entity Type | Organization
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Legal Business Name | ST MICHAEL MEDICAL CENTER INC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 620 NE 128TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4829
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Country | US
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Telephone | 305-981-1015
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Fax | 305-981-1016
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Provider Business Mailing Address
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Address Line | 620 NE 128TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4829
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Country | US
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Telephone | 305-981-1015
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Fax | 305-981-1016
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH M LEMAIRE
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Credential | M.D., M.PH
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Telephone | 305-981-1015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | ME0065663
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License Number State | FL
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