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General NPI Number Information
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NPI Number | 1093109852
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Entity Type | Individual
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Provider Name | JOSHUA FEDE DPT
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Gender | Male
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 2035 N UNIVERSITY DR
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City | SUNRISE
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State | FL
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Zip | 33322-3936
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Country | US
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Telephone | 954-616-1670
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Fax |
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Provider Business Mailing Address
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Address Line | 4311 NW 53RD CT
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4007
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Country | US
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Telephone | 786-683-9226
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Fax |
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 30161
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 30161
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License Number State | FL
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