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General NPI Number Information
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NPI Number | 1164771127
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Entity Type | Organization
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Legal Business Name | ATLANTIC COAST ORTHOPAEDICS, LLC
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 1625 SE 3RD AVE STE 620
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-2521
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Country | US
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Telephone | 954-524-6527
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Fax | 954-527-4938
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Provider Business Mailing Address
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Address Line | 8927 HYPOLUXO RD STE A-4 #157
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City | LAKE WORTH
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State | FL
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Zip | 33467-5262
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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 | MANAGER
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Name | DR. LEROY A SMITH
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Credential | M.D.
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Telephone | 954-415-2633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0014162
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License Number State | FL
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