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General NPI Number Information
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NPI Number | 1578865028
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Entity Type | Organization
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Legal Business Name | PEAK PROVIDER SERVICES, INC
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 01/21/2014
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Provider Practice Location Address
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Address Line | 2435 US HIGHWAY 19 SUITE 540
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City | HOLIDAY
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State | FL
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Zip | 34691-3903
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Country | US
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Telephone | 727-505-0459
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Fax | 727-940-3492
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Provider Business Mailing Address
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Address Line | PO BOX 3970
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City | HOLIDAY
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State | FL
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Zip | 34692-0970
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Country | US
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Telephone | 727-505-0459
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Fax | 727-857-3381
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JEFFREY SCOTT KOCINA
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Credential |
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Telephone | 727-505-0459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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