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General NPI Number Information
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NPI Number | 1710264866
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Entity Type | Organization
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Legal Business Name | MEDICLAIM OF FLORIDA INC
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Dates
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Enumeration Date | 11/03/2011
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 16542 SW 67TH TER
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City | MIAMI
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State | FL
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Zip | 33193-5601
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Country | US
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Telephone | 305-385-4960
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Fax | 305-385-6068
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Provider Business Mailing Address
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Address Line | 16542 SW 67TH TER
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City | MIAMI
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State | FL
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Zip | 33193-5601
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Country | US
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Telephone | 305-385-4960
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Fax | 305-385-6068
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JUAN R CARABALLO
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Credential |
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Telephone | 305-385-4960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State | FL
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