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General NPI Number Information
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NPI Number | 1619166170
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 14437 S DIXIE HWY
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City | MIAMI
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State | FL
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Zip | 33176-7924
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Country | US
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Telephone | 305-256-6020
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Fax | 305-256-6002
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Provider Business Mailing Address
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Address Line | 14437 S DIXIE HWY
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City | MIAMI
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State | FL
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Zip | 33176-7924
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Country | US
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Telephone | 305-256-6020
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Fax | 305-256-6002
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. JASON M. LEVINE
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Credential | D.C.
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Telephone | 305-256-6020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH7845
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License Number State | FL
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