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General NPI Number Information
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NPI Number | 1992124739
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Entity Type | Organization
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Legal Business Name | JM REHABILITATION CENTER CORP
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 3900 NW 79TH AVE STE 591
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City | DORAL
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State | FL
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Zip | 33166-6570
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Country | US
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Telephone | 786-542-5073
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Fax | 305-503-6814
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Provider Business Mailing Address
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Address Line | 3900 NW 79TH AVE STE 591
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City | DORAL
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State | FL
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Zip | 33166-6570
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Country | US
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Telephone | 786-542-5073
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Fax | 305-503-6814
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Authorized Official
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Title or Position | MEDICAL DIRTECTOR
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Name | LYRON BELTZER
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Credential | MD
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Telephone | 786-542-5073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | HCC9063
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License Number State | FL
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