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General NPI Number Information
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NPI Number | 1295603132
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Entity Type | Individual
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Provider Name | MARCELO LIUVAR ALFONSO LABRADA CBHCMS
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Gender | Male
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 4531 DELEON ST STE 207
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City | FORT MYERS
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State | FL
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Zip | 33907-1280
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Country | US
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Telephone | 239-295-0796
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Fax | 239-236-2018
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Provider Business Mailing Address
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Address Line | 3231 STOCKTON ST APT 209
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-1606
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Country | US
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Telephone | 813-648-8019
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CBHCMS0102846
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | CBHCMS0102846
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License Number State | FL
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