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General NPI Number Information
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NPI Number | 1295045086
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Entity Type | Organization
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Legal Business Name | MOBILE MEDICAL SERVICES L.L.C.
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 4304 NORTHCOURSE LN
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City | AVON PARK
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State | FL
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Zip | 33825-8554
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Country | US
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Telephone | 863-257-1542
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Fax | 888-386-8489
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Provider Business Mailing Address
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Address Line | 4304 NORTHCOURSE LN
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City | AVON PARK
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State | FL
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Zip | 33825-8554
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Country | US
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Telephone | 863-257-1542
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Fax | 888-386-8489
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHARON LEE HOOVER
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Credential | ARNP
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Telephone | 863-257-1542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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