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General NPI Number Information
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NPI Number | 1437440237
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Entity Type | Organization
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Legal Business Name | BROWARD PHYSICIANS GROUP OF FLORIDA, LLC
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 2303 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6711
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Country | US
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Telephone | 954-292-6217
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Fax |
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Provider Business Mailing Address
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Address Line | 2303 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6711
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Country | US
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Telephone | 954-292-6217
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Fax |
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Authorized Official
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Title or Position | MGRM
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Name | DR. EMILIO E CASTANEDA
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Credential | M.D.
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Telephone | 954-292-6217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME32388
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License Number State | FL
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