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General NPI Number Information
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NPI Number | 1952502379
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Entity Type | Organization
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Legal Business Name | WELLNESS CARE MEDICAL CENTER INC.
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 1490 W 49TH PL SUITE# 398
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City | HIALEAH
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State | FL
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Zip | 33012-3148
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Country | US
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Telephone | 305-819-2388
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Fax | 305-819-2402
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Provider Business Mailing Address
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Address Line | 1490 W 49TH PL SUITE# 398
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City | HIALEAH
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State | FL
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Zip | 33012-3148
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Country | US
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Telephone | 305-819-2388
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Fax | 305-819-2402
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN M LOVELL
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Credential |
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Telephone | 305-819-2388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | CH5345
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License Number State | FL
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