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NPI 1982707287

NPI 1982707287 : JANNE MARCELA BASANTE OT : MIRAMAR, FL

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General NPI Number Information
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    NPI Number           |    1982707287
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    Entity Type          |    Individual 
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    Provider Name        |    JANNE MARCELA BASANTE OT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/06/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    12730 SW 18TH ST 
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    City                 |    MIRAMAR
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    State                |    FL
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    Zip                  |    33027-2509
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    Country              |    US
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    Telephone            |    786-419-0376
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    12730 SW 18TH ST 
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    City                 |    MIRAMAR
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    State                |    FL
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    Zip                  |    33027-2509
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    Country              |    US
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    Telephone            |    786-419-0376
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    OT 8237
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    License Number State |    FL
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