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General NPI Number Information
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NPI Number | 1629317672
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Entity Type | Organization
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Legal Business Name | ATLANTIS THERAPY SERVICES INC.
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 5703 RED BUG LAKE RD SUITE 518
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4969
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Country | US
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Telephone | 407-629-0444
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Fax | 877-260-0444
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Provider Business Mailing Address
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Address Line | 5703 RED BUG LAKE RD SUITE 518
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4969
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Country | US
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Telephone | 407-629-0444
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Fax | 877-260-0444
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. RENAE FENNELL
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Credential | OTL
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Telephone | 407-629-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 5265
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License Number State | FL
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