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General NPI Number Information
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NPI Number | 1346494051
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Entity Type | Organization
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Legal Business Name | PRO VISION CARE CENTER INC
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Dates
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Enumeration Date | 11/07/2008
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Last Update Date | 01/20/2009
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Provider Practice Location Address
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Address Line | 4763 SW 8TH ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-2546
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Country | US
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Telephone | 305-445-6122
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Fax | 305-445-3041
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Provider Business Mailing Address
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Address Line | 4763 SW 8TH ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-2546
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Country | US
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Telephone | 305-445-6122
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Fax | 305-445-3041
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Authorized Official
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Title or Position | OWNER
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Name | MISS AMALFI BLANCO
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Credential | OD
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Telephone | 786-486-9645
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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 |
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License Number State |
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