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General NPI Number Information
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NPI Number | 1467981613
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Entity Type | Organization
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Legal Business Name | VOLCARE MEDICAL LLC
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 11/22/2017
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Provider Practice Location Address
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Address Line | 2815 ALT 19 STE B
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City | PALM HARBOR
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State | FL
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Zip | 34683-1948
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Country | US
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Telephone | 727-303-3111
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Fax | 727-303-3179
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Provider Business Mailing Address
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Address Line | 7025 FALLBROOK CT
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-4205
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Country | US
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Telephone | 813-293-6009
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. T J MCNICHOL
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Credential | M.D.
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Telephone | 813-293-6009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | ME100254
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License Number State | FL
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