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General NPI Number Information
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NPI Number | 1245698463
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Entity Type | Organization
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Legal Business Name | FHL PSYCHIATRIC SERVICES PLLC
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Dates
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Enumeration Date | 02/02/2016
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 15151 S US HIGHWAY 441 UNIT 300
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City | SUMMERFIELD
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State | FL
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Zip | 34491-4482
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Country | US
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Telephone | 407-280-4890
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Fax | 888-567-3781
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Provider Business Mailing Address
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Address Line | 2675 CEDAR CREST DR
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City | APOPKA
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State | FL
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Zip | 32712-5019
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Country | US
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Telephone | 407-280-4890
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Fax | 888-567-3781
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | CARLES SICARD
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Credential | M.D.
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Telephone | 410-322-4575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | ME118567
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License Number State | FL
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