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General NPI Number Information
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NPI Number | 1689941296
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Entity Type | Organization
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Legal Business Name | EXCELLENT REHAB AND MEDICAL STAFFING CENTER, INC.
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Dates
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Enumeration Date | 11/27/2011
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Last Update Date | 11/27/2011
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Provider Practice Location Address
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Address Line | 782 NW 42ND AVE SUITE#635
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City | MIAMI
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State | FL
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Zip | 33126-5541
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Country | US
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Telephone | 305-444-4669
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Fax | 305-444-4633
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Provider Business Mailing Address
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Address Line | 782 NW 42ND AVE SUITE#635
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City | MIAMI
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State | FL
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Zip | 33126-5541
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Country | US
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Telephone | 305-444-4669
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Fax | 305-444-4633
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Authorized Official
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Title or Position | OWNER
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Name | MR. EDUARDO BENITEZ I
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Credential | OWNER
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Telephone | 305-444-4669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC9513
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License Number State | FL
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