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General NPI Number Information
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NPI Number | 1376859306
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Entity Type | Individual
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Provider Name | RAYNALD MICHEL D.D.S
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Gender | Male
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 3051 N FEDERAL HWY SUITE 1
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1456
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Country | US
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Telephone | 954-573-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 3051 N FEDERAL HWY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1456
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Country | US
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Telephone | 954-563-5800
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN19473
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License Number State | FL
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