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General NPI Number Information
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NPI Number | 1619013661
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Entity Type | Organization
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Legal Business Name | DEVINE HOMECARE SERVICES
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2086 CAMELOT BLVD
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City | SAINT CLOUD
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State | FL
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Zip | 34772-7001
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Country | US
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Telephone | 407-892-9194
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Fax | 407-892-9194
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Provider Business Mailing Address
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Address Line | 2086 CAMELOT BLVD
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City | SAINT CLOUD
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State | FL
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Zip | 34772-7001
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Country | US
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Telephone | 407-892-9194
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Fax | 407-892-9194
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DIANE M ESPOSITO
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Credential | L.P.N.
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Telephone | 407-892-9194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PN1298251
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | G06216900262
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License Number State | FL
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