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General NPI Number Information
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NPI Number | 1194576231
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Entity Type | Organization
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Legal Business Name | DR KAY LLC
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 2716 STONEWOOD PARK LOOP
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City | LAND O LAKES
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State | FL
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Zip | 34638-6213
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Country | US
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Telephone | 469-915-4211
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Fax |
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Provider Business Mailing Address
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Address Line | 5230 LAND O LAKES BLVD UNIT 1015
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City | LAND O LAKES
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State | FL
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Zip | 34639-3241
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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 | AL BERRY
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Credential |
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Telephone | 469-915-4211
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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 |
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License Number State |
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