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General NPI Number Information
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NPI Number | 1255630554
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Entity Type | Organization
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Legal Business Name | WESTLAKE EMERGENCY MEDICAL ASSOCIATES & CONSULTANTS, LLC
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Dates
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Enumeration Date | 03/25/2011
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Last Update Date | 03/25/2011
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Provider Practice Location Address
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Address Line | 159 N 3RD ST
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City | MACCLENNY
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State | FL
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Zip | 32063-2103
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Country | US
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Telephone | 904-259-3151
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Fax |
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Provider Business Mailing Address
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Address Line | 9526 ARGYLE FOREST BLVD SUITE B2 #304
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City | JACKSONVILLE
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State | FL
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Zip | 32222-2825
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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 | SOLE OWNER
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Name | JUDY SCHROEDER
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Credential |
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Telephone | 904-437-7830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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