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General NPI Number Information
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NPI Number | 1407666357
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Entity Type | Individual
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Provider Name | ALINE MICHELE LEUTZ DA SILVA GODINHO PT
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Gender | Female
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 1180 SPRING CENTRE S. BLVD STE 225
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City | ALTMONTE SPRINGS
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State | FL
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Zip | 32714
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Country | US
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Telephone | 407-495-1165
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Fax | 800-688-2049
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Provider Business Mailing Address
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Address Line | 5689 NEW INDEPENDENCE PKWY
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City | WINTER GARDEN
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State | FL
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Zip | 34787
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Country | US
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Telephone | 407-244-0547
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT42627
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License Number State | FL
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