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NPI 1629422936

NPI 1629422936 : MIAMI SUPPORT SERVICES, CORP. : NARANJA, FL

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General NPI Number Information
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    NPI Number           |    1629422936
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    Entity Type          |    Organization 
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    Legal Business Name  |    MIAMI SUPPORT SERVICES, CORP. 
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Dates
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    Enumeration Date     |    04/22/2016
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    Last Update Date     |    04/22/2016
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Provider Practice Location Address
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    Address Line         |    14341 SW 268TH ST APT 204 
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    City                 |    NARANJA
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    State                |    FL
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    Zip                  |    33032-7184
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    Country              |    US
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    Telephone            |    786-295-9586
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14341 SW 268TH ST APT 204 
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    City                 |    NARANJA
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    State                |    FL
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    Zip                  |    33032-7184
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    Country              |    US
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    Telephone            |    786-295-9586
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     MARIBEL  CASTILLO 
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    Credential           |    
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    Telephone            |    786-295-9586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251C00000X
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    Taxonomy Name        |    Developmentally Disabled Services Day Training Agency
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    License Number       |    
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    License Number State |    
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