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General NPI Number Information
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NPI Number | 1427808757
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Entity Type | Organization
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Legal Business Name | ALARICHEALTHLAKECITY, INC
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 455 EDGEWOOD AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32205-3727
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Country | US
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Telephone | 904-384-9007
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Fax | 904-384-2899
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Provider Business Mailing Address
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Address Line | 455 EDGEWOOD AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32205-3727
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Country | US
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Telephone | 904-384-9007
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Fax | 904-384-2899
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Authorized Official
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Title or Position | OWNER
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Name | JAMES C WHITED JR.
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Credential | APRN
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Telephone | 904-384-9007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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