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General NPI Number Information
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NPI Number | 1871533737
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Entity Type | Organization
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Legal Business Name | COMPLETE MEDICAL REHAB & FAMILY
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 11348 QUAIL ROOST DR
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City | MIAMI
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State | FL
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Zip | 33157-6567
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Country | US
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Telephone | 305-253-1660
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Fax | 305-253-5775
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Provider Business Mailing Address
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Address Line | 11348 QUAIL ROOST DR
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City | MIAMI
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State | FL
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Zip | 33157-6567
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Country | US
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Telephone | 305-253-1660
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Fax | 305-253-5775
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Authorized Official
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Title or Position | PRESIDENT
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Name | HUMBERTO L BOGANI
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Credential |
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Telephone | 305-253-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | HCC5174
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License Number State | FL
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