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General NPI Number Information
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NPI Number | 1659633188
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Entity Type | Organization
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Legal Business Name | C&C MEDICAL CENTER INC.
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/17/2014
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Provider Practice Location Address
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Address Line | 7100 W 20TH AVE STE 412
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City | HIALEAH
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State | FL
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Zip | 33016-1811
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Country | US
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Telephone | 305-819-6353
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Fax |
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Provider Business Mailing Address
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Address Line | 7100 W 20TH AVE SUITE 412
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City | HIALEAH
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State | FL
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Zip | 33016-1811
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Country | US
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Telephone | 305-819-6353
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MILAGROS TORRES
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Credential | MA 66278
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Telephone | 305-819-6353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | MA66278
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License Number State | FL
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