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General NPI Number Information
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NPI Number | 1023047834
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Entity Type | Individual
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Provider Name | MYVANNE LUMAPAS JURGRAU PT
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Gender | Female
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 4480 NW 49TH CT
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City | COCONUT CREEK
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State | FL
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Zip | 33073-2922
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Country | US
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Telephone | 954-801-3435
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Fax | 954-708-2466
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Provider Business Mailing Address
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Address Line | 4480 NW 49TH CT
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City | COCONUT CREEK
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State | FL
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Zip | 33073-2922
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Country | US
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Telephone | 954-801-3435
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Fax | 954-708-2466
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT22539
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License Number State | FL
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