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General NPI Number Information
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NPI Number | 1114268794
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Entity Type | Organization
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Legal Business Name | VISION EXPRESS LLC
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 9501 ARLINGTON EXPRESSWAY #340
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City | JACKSONVILLE
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State | FL
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Zip | 32225-8209
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Country | US
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Telephone | 904-418-8339
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Fax | 904-701-9507
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Provider Business Mailing Address
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Address Line | 14964 MAX LEGGETT PARKWAY #106
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City | JACKSONVILLE
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State | FL
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Zip | 32218-7235
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Country | US
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Telephone | 904-418-8339
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Fax | 904-701-9507
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MRS. ALLISON A FALDEN
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Credential | OD
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Telephone | 904-418-8339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number |
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License Number State | FL
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Taxonomy #2
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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 | FL
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