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General NPI Number Information
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NPI Number | 1003157017
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Entity Type | Individual
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Provider Name | TOMAS WHARTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2013
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 311 NE 8TH ST STE 110
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City | HOMESTEAD
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State | FL
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Zip | 33030-4734
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Country | US
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Telephone | 718-219-7927
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Fax | 718-597-5242
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Provider Business Mailing Address
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Address Line | 311 NE 8TH ST STE 110
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City | HOMESTEAD
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State | FL
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Zip | 33030-4734
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Country | US
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Telephone | 718-219-7927
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Fax | 718-597-5242
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN 586
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License Number State | FL
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