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General NPI Number Information
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NPI Number | 1255380333
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Entity Type | Organization
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Legal Business Name | ANGELS MEDICAL SERVICE INC.
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 6043 NW 167 STREET STE A-27
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City | MIAMI LAKES
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State | FL
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Zip | 33015
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Country | US
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Telephone | 305-805-9606
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Fax |
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Provider Business Mailing Address
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Address Line | 7871 NW 169TH TER
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City | MIAMI LAKES
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State | FL
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Zip | 33016-3428
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA BOADA
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Credential |
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Telephone | 305-817-3081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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