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General NPI Number Information
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NPI Number | 1225318975
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Entity Type | Individual
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Provider Name | MICHELLE LEVIN O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 04/14/2019
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Provider Practice Location Address
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Address Line | 777 E 25TH ST STE 412-414
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City | HIALEAH
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State | FL
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Zip | 33013
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Country | US
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Telephone | 305-835-7588
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Fax | 305-835-6372
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Provider Business Mailing Address
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Address Line | 1039 CREEKFORD DR
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City | WESTON
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State | FL
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Zip | 33326-2859
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Country | US
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Telephone | 954-439-2192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4645
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License Number State | FL
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