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General NPI Number Information
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NPI Number | 1437485927
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 10/21/2009
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Provider Practice Location Address
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Address Line | 11348 QUAIL ROOST DR
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City | MIAMI
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State | FL
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Zip | 33157-6567
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Country | US
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Telephone | 786-387-9386
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Fax | 305-253-5775
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Provider Business Mailing Address
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Address Line | 1500 NW 10TH AVE SUITE #104
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City | BOCA RATON
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State | FL
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Zip | 33486-1312
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Country | US
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Telephone | 786-387-9386
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS R ZALDIVAR
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Credential | PH.D.
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Telephone | 786-387-9386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | PY003628
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License Number State | FL
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