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NPI 1245482892

NPI 1245482892 : SHEILA ANN CONNERTON PTA : JUPITER, FL

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General NPI Number Information
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    NPI Number           |    1245482892
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    Entity Type          |    Individual 
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    Provider Name        |    SHEILA ANN CONNERTON PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/15/2008
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    Last Update Date     |    10/15/2008
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Provider Practice Location Address
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    Address Line         |    2055 MILITARY TRL STE 200 
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    City                 |    JUPITER
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    State                |    FL
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    Zip                  |    33458-7830
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    Country              |    US
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    Telephone            |    561-744-4114
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    43 MAPLECREST CIR 
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    City                 |    JUPITER
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    State                |    FL
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    Zip                  |    33458-7805
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    Country              |    US
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    Telephone            |    561-575-2519
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    PTA1455
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    License Number State |    FL
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