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NPI 1003512104

NPI 1003512104 : SHIRA PALGON : BOCA RATON, FL

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General NPI Number Information
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    NPI Number           |    1003512104
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    Entity Type          |    Individual 
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    Provider Name        |    SHIRA PALGON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/01/2023
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    Last Update Date     |    02/22/2023
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Provider Practice Location Address
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    Address Line         |    7735 STANWAY PL E 
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    City                 |    BOCA RATON
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    State                |    FL
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    Zip                  |    33433-3306
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    Country              |    US
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    Telephone            |    914-882-0615
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7735 STANWAY PL E 
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    City                 |    BOCA RATON
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    State                |    FL
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    Zip                  |    33433-3306
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    Country              |    US
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    Telephone            |    914-882-0615
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    Fax                  |    
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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        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    5A20226
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    License Number State |    FL
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