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General NPI Number Information
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NPI Number | 1689373896
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Entity Type | Organization
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Legal Business Name | MODERNISTIC HEALTH CARE SERVICES INC
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 12/10/2023
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Provider Practice Location Address
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Address Line | 11322 MIRAMAR PKWY # 1214
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City | MIRAMAR
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State | FL
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Zip | 33025-5805
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Country | US
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Telephone | 833-663-3760
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Fax |
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Provider Business Mailing Address
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Address Line | 2090 W PRESERVE WAY APT 304
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City | MIRAMAR
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State | FL
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Zip | 33025-3909
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Country | US
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Telephone | 954-822-5363
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHERINE BAILEY
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Credential | APRN
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Telephone | 954-822-5363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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