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General NPI Number Information
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NPI Number | 1144331893
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Entity Type | Individual
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Provider Name | LAWRENCE M LEVINE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 580 W 8TH ST UFJP OPHTHALMLOLOGY
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6533
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Country | US
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Telephone | 904-244-9390
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Fax |
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Provider Business Mailing Address
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Address Line | 2023 PROFESSIONAL CENTER DR
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City | ORANGE PARK
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State | FL
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Zip | 32073
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Country | US
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Telephone | 904-272-2020
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Fax | 904-276-4386
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME80215
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License Number State | FL
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