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General NPI Number Information
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NPI Number | 1295239051
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Entity Type | Organization
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Legal Business Name | LOU HAROLD MD
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 1173 BLACKWOOD AVE
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City | OCOEE
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State | FL
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Zip | 34761-4518
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Country | US
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Telephone | 407-839-3700
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Fax | 407-839-0640
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Provider Business Mailing Address
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Address Line | 1173 BLACKWOOD AVE
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City | OCOEE
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State | FL
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Zip | 34761-4518
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Country | US
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Telephone | 407-839-3700
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Fax | 407-839-0640
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOU HAROLD
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Credential | MD
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Telephone | 407-839-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME047257
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License Number State | FL
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