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General NPI Number Information
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NPI Number | 1669891057
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Entity Type | Organization
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Legal Business Name | STAFFINGRUS LLC
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/14/2014
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Provider Practice Location Address
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Address Line | 1300 NW 17TH AVE SUITE 273 D
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City | DELRAY BEACH
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State | FL
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Zip | 33445-2578
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Country | US
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Telephone | 561-276-2602
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Fax | 954-278-8458
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Provider Business Mailing Address
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Address Line | 4015 BANYAN TRAILS DR
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City | COCONUT CREEK
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State | FL
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Zip | 33073-5101
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Country | US
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Telephone | 954-513-7555
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Fax | 954-278-8458
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOAN WILLIAMS
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Credential | RN
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Telephone | 954-513-7555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | NR30211644
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License Number State | FL
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