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General NPI Number Information
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NPI Number | 1407093412
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Entity Type | Organization
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Legal Business Name | VITAL CARE MEDICAL CENTER, INC
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 09/17/2016
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Provider Practice Location Address
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Address Line | 2188 JOG ROAD
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City | GREENACRES
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State | FL
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Zip | 33415
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Country | US
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Telephone | 561-439-0850
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Fax | 561-439-0819
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Provider Business Mailing Address
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Address Line | 2188 JOG ROAD
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City | GREENACRES
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State | FL
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Zip | 33415
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Country | US
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Telephone | 561-439-0850
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Fax | 561-439-0819
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Authorized Official
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Title or Position | PHYSICIAN, OWNER
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Name | MR. ADAM K. BERRY
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Credential | MD
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Telephone | 561-439-0850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | HCC8337
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License Number State | FL
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