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General NPI Number Information
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NPI Number | 1891780011
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Entity Type | Organization
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Legal Business Name | CAMELOT HEALTHCARE MANAGEMENT INC
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 1141 JOHN SIMS PKWY EAST
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City | NICEVILLE
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State | FL
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Zip | 32578
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Country | US
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Telephone | 850-729-1166
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Fax | 850-678-9245
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Provider Business Mailing Address
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Address Line | 4656 SW 74 AVE
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City | MIAMI
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State | FL
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Zip | 33155
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Country | US
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Telephone | 305-267-2278
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Fax | 305-267-2279
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANGEL ARCIERO
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Credential |
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Telephone | 305-267-2278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | HME906
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | HME906
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License Number State | FL
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