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General NPI Number Information
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NPI Number | 1013121011
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Entity Type | Individual
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Provider Name | RENEE BOCCIO DC
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 2090 OLD HICKORY TREE RD STE 107
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City | SAINT CLOUD
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State | FL
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Zip | 34772-8901
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Country | US
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Telephone | 407-593-1273
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Fax | 352-353-4717
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Provider Business Mailing Address
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Address Line | 2090 OLD HICKORY TREE RD STE 107
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City | SAINT CLOUD
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State | FL
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Zip | 34772-8901
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Country | US
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Telephone | 407-593-1273
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Fax | 352-353-4717
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010111
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License Number State | NY
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