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NPI 1548700115

NPI 1548700115 : I AM HEALTHY, LLC : APOPKA, FL

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General NPI Number Information
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    NPI Number           |    1548700115
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    Entity Type          |    Organization 
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    Legal Business Name  |    I AM HEALTHY, LLC 
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Dates
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    Enumeration Date     |    03/02/2017
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    Last Update Date     |    04/12/2021
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Provider Practice Location Address
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    Address Line         |    201 N PARK AVE STE 201 
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    City                 |    APOPKA
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    State                |    FL
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    Zip                  |    32703-4147
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    Country              |    US
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    Telephone            |    407-814-2680
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    Fax                  |    407-814-2068
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Provider Business Mailing Address
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    Address Line         |    201 N PARK AVE STE 201 
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    City                 |    APOPKA
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    State                |    FL
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    Zip                  |    32703-4147
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    Country              |    US
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    Telephone            |    407-814-2680
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    Fax                  |    407-814-2068
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Authorized Official
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    Title or Position    |    D.O./OWNER
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    Name                 |    DR. JASON LAMONT SALAGUBANG 
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    Credential           |    M.D.
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    Telephone            |    407-814-2680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207QG0300X
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    Taxonomy Name        |    Geriatric Medicine (Family Medicine) Physician
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    License Number       |    ME 87564
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    ME87564
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    License Number State |    FL
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