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General NPI Number Information
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NPI Number | 1083123418
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Entity Type | Organization
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Legal Business Name | MAXIMEYES VISION, INC.
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1500 S ORANGE BLOSSOM TRAIL
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City | APOPKA
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State | FL
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Zip | 32703
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Country | US
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Telephone | 407-553-4105
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 CITRUS AVE UNIT 652
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City | GOLDENROD
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State | FL
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Zip | 32733-5527
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOELLE RODRIGUEZ
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Credential |
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Telephone | 407-773-5111
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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 |
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License Number State |
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