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General NPI Number Information
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NPI Number | 1144686171
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Entity Type | Organization
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Legal Business Name | VCS MEDICAL ASSOCIATES CORP
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 6979 HANCOCK DR
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-8207
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Country | US
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Telephone | 844-201-9009
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Fax | 844-656-1444
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Provider Business Mailing Address
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Address Line | 6979 HANCOCK DR
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-8207
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Country | US
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Telephone | 844-201-9009
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Fax | 844-656-1444
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. SURESH SUKHRAJ
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Credential |
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Telephone | 772-812-4475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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