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General NPI Number Information
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NPI Number | 1700048196
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Entity Type | Organization
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Legal Business Name | TROPICAL HAVEN, INC.
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 460 NW 40TH CT
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City | OAKLAND PARK
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State | FL
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Zip | 33309-5138
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Country | US
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Telephone | 954-565-0022
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Fax | 954-565-7617
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Provider Business Mailing Address
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Address Line | 5540 NW 49TH WAY
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City | COCONUT CREEK
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State | FL
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Zip | 33073-3724
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Country | US
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Telephone | 954-937-5541
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Fax | 954-596-9048
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GARY E SMITH
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Credential |
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Telephone | 954-937-5541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL7480
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License Number State | FL
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