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NPI 1801433065

NPI 1801433065 : DIXIE COMMUNITY CARE INC : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1801433065
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    Entity Type          |    Organization 
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    Legal Business Name  |    DIXIE COMMUNITY CARE INC 
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Dates
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    Enumeration Date     |    12/06/2019
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    Last Update Date     |    12/06/2019
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Provider Practice Location Address
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    Address Line         |    15715 S DIXIE HWY STE 211 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33157-1875
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    Country              |    US
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    Telephone            |    786-370-8755
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    15715 S DIXIE HWY STE 211 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33157-1875
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    Country              |    US
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    Telephone            |    786-370-8755
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     OSCAR  BENITEZ DOMINGUEZ 
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    Credential           |    CBHCMS
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    Telephone            |    786-370-8755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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    License Number       |    
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    License Number State |    
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