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General NPI Number Information
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NPI Number | 1932019064
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Entity Type | Organization
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Legal Business Name | AMAVIDA OPTIMAL HEALTH LLC
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 1 BESTOR LN
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City | BLOOMFIELD
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State | CT
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Zip | 06002-2485
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Country | US
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Telephone | 860-206-2122
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Fax | 860-243-3315
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Provider Business Mailing Address
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Address Line | 1 BESTOR LN
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City | BLOOMFIELD
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State | CT
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Zip | 06002-2485
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Country | US
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Telephone | 860-206-2122
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Fax | 860-243-3315
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. ROCHELLE COLLINS
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Credential | DO
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Telephone | 860-206-2122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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