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General NPI Number Information
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NPI Number | 1417019357
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Entity Type | Organization
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Legal Business Name | MENTAL WELLNESS CENTER
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 1735 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-3501
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Country | US
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Telephone | 305-442-9020
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Fax | 305-442-8284
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Provider Business Mailing Address
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Address Line | 1735 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-3501
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Country | US
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Telephone | 305-442-9020
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Fax | 305-442-8284
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. SANFORD RAKOFSKY I
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Credential | M.D.
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Telephone | 305-442-9020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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