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General NPI Number Information
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NPI Number | 1760649412
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Entity Type | Organization
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Legal Business Name | CMFMC INC
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 150 WILLOW DR
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City | ORLANDO
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State | FL
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Zip | 32807-3222
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Country | US
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Telephone | 407-282-0556
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Fax | 407-282-2231
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Provider Business Mailing Address
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Address Line | 150 WILLOW DR
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City | ORLANDO
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State | FL
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Zip | 32807-3222
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Country | US
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Telephone | 407-282-0556
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Fax | 407-282-2231
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. PROSERFINO PATACSIL
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Credential |
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Telephone | 407-282-0556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL4839
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License Number State | FL
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