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General NPI Number Information
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NPI Number | 1063680528
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Entity Type | Organization
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Legal Business Name | OKALOOSA PULMONARY & SLEEP MEDICINE CLINIC
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 02/18/2008
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Provider Practice Location Address
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Address Line | 131 E REDSTONE AVE SUITE 105
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City | CRESTVIEW
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State | FL
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Zip | 32539-5326
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Country | US
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Telephone | 850-423-0561
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Fax | 850-682-0141
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Provider Business Mailing Address
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Address Line | 131 E REDSTONE AVE SUITE 105
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City | CRESTVIEW
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State | FL
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Zip | 32539-5326
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Country | US
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Telephone | 850-423-0561
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Fax | 850-682-0141
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Authorized Official
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Title or Position | DR/OWNER/PRESIDENT
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Name | DR. DEBORAH A MILKOWSKI
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Credential | MD, FCCP
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Telephone | 850-423-0561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME93191
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License Number State | FL
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