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General NPI Number Information
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NPI Number | 1669830626
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Entity Type | Organization
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Legal Business Name | CHRONIC CARE SOLUTIONS
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 8618 SW 103RD STREET RD
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City | OCALA
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State | FL
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Zip | 34481-7705
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Country | US
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Telephone | 352-304-8980
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Fax |
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Provider Business Mailing Address
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Address Line | 5029 SE 5TH AVE
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City | OCALA
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State | FL
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Zip | 34480-2748
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Country | US
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Telephone | 352-304-8980
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEERTINI KUMAR
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Credential | M.D.
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Telephone | 352-304-8980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME87056
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License Number State | FL
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