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General NPI Number Information
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NPI Number | 1376118299
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Entity Type | Organization
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Legal Business Name | HOLISTIC HEALTH & MEDICAL, INC.
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 14750 NW 77TH CT STE 114
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1507
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Country | US
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Telephone | 786-536-8411
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Fax |
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Provider Business Mailing Address
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Address Line | 14750 NW 77TH CT STE 114
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1507
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Country | US
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Telephone | 786-536-8411
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Fax |
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Authorized Official
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Title or Position | DPT
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Name | ORLANDO VIJAY WALTER
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Credential | DPT
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Telephone | 786-536-8411
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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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