TARGETED CASE MANAGEMENT ENROLLMENT TIPS
CLIA License number: Leave Blank. NPI Number: Enter the individual’s nine-digit NPI number. Medicare Number: Leave Blank . Provider Handbooks: Check box if you wish to receive provider handbooks by mail. Collaboration Agreement for Individual PA and APRN ARNP: Requires a CMS physician or dentist to sign and provide his/her Florida license number. ................
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