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General NPI Number Information
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NPI Number | 1063653632
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Entity Type | Organization
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Legal Business Name | MICHAEL DALESIO OD P A
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 8001 US HIGHWAY 19 N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-1744
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Country | US
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Telephone | 727-568-0385
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Fax | 727-578-5922
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Provider Business Mailing Address
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Address Line | 2241 SPRINGRAIN DR
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City | CLEARWATER
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State | FL
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Zip | 33763-2238
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Country | US
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Telephone | 727-687-5638
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL EUGENE D'ALESIO
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Credential | O.D.
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Telephone | 727-687-5638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2032
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License Number State | FL
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