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General NPI Number Information
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NPI Number | 1932575404
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Entity Type | Organization
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Legal Business Name | A RAY OF SUNSHINE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 11356 SEA GRASS CIR
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City | BOCA RATON
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State | FL
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Zip | 33498-4919
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Country | US
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Telephone | 561-252-6287
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Fax |
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Provider Business Mailing Address
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Address Line | 11356 SEA GRASS CIR
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City | BOCA RATON
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State | FL
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Zip | 33498-4919
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Country | US
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Telephone | 561-252-6287
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE FORMAN
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Credential | MSPT
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Telephone | 561-252-6287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT21310
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License Number State | FL
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