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General NPI Number Information
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NPI Number | 1164818829
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Entity Type | Organization
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Legal Business Name | COMPLEMED, LLC
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 2718 WINDGUARD CIRCLE SUITE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544
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Country | US
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Telephone | 813-388-6865
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Fax | 813-388-6866
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Provider Business Mailing Address
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Address Line | 2718 WINDGUARD CIRCLE SUITE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544
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Country | US
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Telephone | 813-388-6865
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Fax | 813-388-6866
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE MARGARET BIEN
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Credential | DO
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Telephone | 813-388-6865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS5723
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License Number State | FL
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