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General NPI Number Information
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NPI Number | 1619166469
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Entity Type | Organization
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Legal Business Name | ARTHRITIS CARE CENTRE, LLC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 1840 MEASE DR # 406
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-6602
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Country | US
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Telephone | 727-669-4418
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Fax | 727-669-3915
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Provider Business Mailing Address
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Address Line | 1840 MEASE DR # 406
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-6602
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Country | US
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Telephone | 727-669-4418
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Fax | 727-669-3915
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Authorized Official
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Title or Position | OWNER
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Name | DR. LESLIE A GOODMAN
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Credential | M.D.
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Telephone | 727-669-4418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0046928
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License Number State | NY
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