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General NPI Number Information
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NPI Number | 1801199237
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Entity Type | Organization
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Legal Business Name | CHECKMATE INC
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 2753 STARDUST CT CT#9
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City | JACKSONVILLE
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State | FL
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Zip | 32211-2808
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Country | US
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Telephone | 786-344-5284
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Fax |
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Provider Business Mailing Address
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Address Line | 2753 STARDUST CT CT #9
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City | JACKSONVILLE
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State | FL
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Zip | 32211-2808
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Country | US
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Telephone | 786-344-5284
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES LEON WATSON SR.
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Credential |
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Telephone | 786-344-5284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 616231
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 616231
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 616231
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 616231
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 616231
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License Number State | FL
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