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General NPI Number Information
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NPI Number | 1952196503
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Entity Type | Organization
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Legal Business Name | REVIVE CHIROPRACTIC CARE, LLC
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 8949 W COLONIAL DR
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City | OCOEE
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State | FL
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Zip | 34761-6918
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Country | US
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Telephone | 321-945-3928
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Fax |
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Provider Business Mailing Address
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Address Line | 8949 W COLONIAL DR
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City | OCOEE
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State | FL
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Zip | 34761-6918
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Country | US
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Telephone | 321-945-3928
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. FARAH C CINOUS
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Credential | DC
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Telephone | 321-945-3928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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