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General NPI Number Information
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NPI Number | 1508275728
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Entity Type | Organization
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Legal Business Name | US REHABILITATION CENTER INC
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Dates
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Enumeration Date | 08/13/2014
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 2400 W 2ND AVE STE 4
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City | HIALEAH
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State | FL
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Zip | 33010-1518
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Country | US
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Telephone | 786-261-6250
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Fax | 786-345-5930
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Provider Business Mailing Address
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Address Line | 2400 W 2ND AVE STE 4
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City | HIALEAH
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State | FL
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Zip | 33010-1518
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Country | US
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Telephone | 305-796-9208
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Fax | 786-345-5930
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | CARLOS BLANCO
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Credential | MD
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Telephone | 305-796-9208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME71266
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License Number State | FL
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