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General NPI Number Information
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NPI Number | 1669640157
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Entity Type | Organization
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Legal Business Name | ALL STAR REHABILITATION CENTER INC
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 5881 NW 151ST ST SUITE 120
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2450
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Country | US
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Telephone | 305-826-1831
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Fax | 305-826-1844
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Provider Business Mailing Address
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Address Line | 5881 NW 151ST ST SUITE 120
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2450
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Country | US
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Telephone | 305-826-1831
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Fax | 305-826-1844
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Authorized Official
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Title or Position | OWNER
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Name | MS. ILEANA CALVO
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Credential |
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Telephone | 305-826-1831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2008-3274
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License Number State | FL
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