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General NPI Number Information
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NPI Number | 1558144782
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Entity Type | Organization
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Legal Business Name | MEDICAL REHAB PRO LLC
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 901 45TH STREET REHAB ADMIN
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City | WEST PALM BEACH
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State | FL
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Zip | 33407
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Country | US
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Telephone | 855-850-7032
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Fax | 772-223-8938
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Provider Business Mailing Address
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Address Line | 410 EVERNIA ST APT 511
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5436
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Country | US
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Telephone | 917-751-4262
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Fax | 772-223-8938
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | MS. DIANE ANTIONETTE THOMPSON
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Credential | MD
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Telephone | 917-751-4262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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