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General NPI Number Information
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NPI Number | 1497366256
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Entity Type | Organization
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Legal Business Name | AMERICAN COMMUNITY HEALTH AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 3241 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-4139
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Country | US
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Telephone | 786-439-8048
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Fax |
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Provider Business Mailing Address
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Address Line | 3241 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-4139
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Country | US
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Telephone | 786-439-8048
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSE YALIAN BENITEZ
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Credential |
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Telephone | 786-439-8048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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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 | 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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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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