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  • 687049
CCN: 687049 NPI: 1427323385 Organization

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29750 US HIGHWAY 19 N STE 203
CLEARWATER, FL 337611510

Contact Information

  • Phone 7273307844
  • Fax 7274709594
  • Enumeration Date 2012-03-12
  • Last Updated 2022-10-18

Taxonomies

  • Code: 251E00000X (Primary) License State: FL License: 299994008

Inpatient Payment Attributes (IPSF) View Dictionary →

censusDivision 3
cbsaActualGeographicLocation 45300
providerType 36
censusDivision 3
cbsaActualGeographicLocation 45300
providerType 36
censusDivision 3
cbsaActualGeographicLocation 45300
providerType 36
censusDivision 3
cbsaActualGeographicLocation 45300
providerType 36
censusDivision 3
cbsaActualGeographicLocation 45300
providerType 36
censusDivision 3
cbsaActualGeographicLocation 45300
providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

cbsaActualGeographicLocation 45300
providerType 36
specialPaymentIndicator
carrierCode 09102
localityCode 99
cbsaActualGeographicLocation 45300
providerType 36
specialPaymentIndicator
carrierCode 09102
localityCode 99
cbsaActualGeographicLocation 45300
providerType 36
specialPaymentIndicator
carrierCode 09102
localityCode 99

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