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General NPI Number Information
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NPI Number | 1205709896
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Entity Type | Organization
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Legal Business Name | BEACON CHIRO AND WELLNESS PLLC
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 5517 S WILLIAMSON BLVD STE 305
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City | PORT ORANGE
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State | FL
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Zip | 32128-8310
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Country | US
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Telephone | 386-444-7700
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Fax | 386-444-7070
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Provider Business Mailing Address
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Address Line | 5517 S WILLIAMSON BLVD STE 305
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City | PORT ORANGE
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State | FL
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Zip | 32128-8310
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Country | US
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Telephone | 386-444-7700
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Fax | 386-444-7070
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Authorized Official
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Title or Position | CLINIC OWNER/CHIROPRACTOR
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Name | DIONES VALENTIN
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Credential | DC
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Telephone | 787-407-4535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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