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General NPI Number Information
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NPI Number | 1659886992
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Entity Type | Organization
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Legal Business Name | SMH PHYSICIAN SERVICES INC
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1921 WALDEMERE ST STE 701
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City | SARASOTA
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State | FL
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Zip | 34239-2913
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Country | US
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Telephone | 941-487-2160
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Fax | 941-487-2170
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Provider Business Mailing Address
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Address Line | PO BOX 863407
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City | ORLANDO
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State | FL
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Zip | 32886-3407
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Country | US
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Telephone | 941-917-2600
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Fax | 941-917-7884
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MICHELLE A SHIREY
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Credential |
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Telephone | 941-917-8720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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