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General NPI Number Information
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NPI Number | 1356493605
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Entity Type | Organization
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Legal Business Name | ALTAMONTE SPRINGS INJURY CLINIC LLC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 106 BOSTON AVE SUITE 202
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4731
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Country | US
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Telephone | 407-920-6735
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Fax |
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Provider Business Mailing Address
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Address Line | 106 BOSTON AVE SUITE 202
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4731
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Country | US
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Telephone | 407-906-0077
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL SOFER
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Credential | D.C.
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Telephone | 407-906-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH9213
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License Number State | FL
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