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NPI 1487830410

NPI 1487830410 : SPEEDYREEMPLOYMENT & MEDICARE SET-ASIDE : DELRAY BEACH, FL

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General NPI Number Information
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    NPI Number           |    1487830410
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    Entity Type          |    Organization 
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    Legal Business Name  |    SPEEDYREEMPLOYMENT & MEDICARE SET-ASIDE 
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Dates
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    Enumeration Date     |    01/22/2008
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    Last Update Date     |    01/22/2008
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Provider Practice Location Address
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    Address Line         |    223 NE 5TH AVE 
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    City                 |    DELRAY BEACH
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    State                |    FL
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    Zip                  |    33483-5530
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    Country              |    US
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    Telephone            |    800-824-0100
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    Fax                  |    800-985-3391
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Provider Business Mailing Address
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    Address Line         |    223 NE 5TH AVE 
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    City                 |    DELRAY BEACH
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    State                |    FL
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    Zip                  |    33483-5530
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    Country              |    US
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    Telephone            |    800-824-0100
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    Fax                  |    800-985-3391
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MR. JOE  MCCULLOUGH 
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    Credential           |    
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    Telephone            |    800-824-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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    License Number       |    
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    License Number State |    
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