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Hometown Pediatrics LLC 1400 US Hwy 441N Suite 522 The Villages FL 32159 352-560-PEDS 7337 New Patient Information Form Date Child s Name Previous Physician/Office Mom s Name Age Child lives with Nickname DOB Request for records transfer completed Y N Date of Last Physical Dad s Name M F Form completed by BIRTH HISTORY Birth Weight Preg Mom s Age Was the baby born on time Early Late If early how many weeks gestation Did mother have any illness or problems with her pregnancy Y N Explain...
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Remember, it is always advisable to consult with legal and tax professionals before starting any business venture to ensure compliance with all applicable laws and regulations.
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Hometown Pediatrics LLC is a pediatric medical practice located in a specific town.
The owners or operators of Hometown Pediatrics LLC are required to file the necessary paperwork with the appropriate authorities.
To fill out the paperwork for Hometown Pediatrics LLC, one must gather all necessary information about the business and submit it according to the instructions provided.
The purpose of Hometown Pediatrics LLC is to provide pediatric medical services to children in the local community.
Information such as business name, address, ownership details, and financial information may need to be reported on Hometown Pediatrics LLC.
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