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General NPI Number Information
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NPI Number | 1396718128
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Entity Type | Individual
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Provider Name | WILLIAM JOSEPH BENTZ D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 05/24/2017
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Provider Practice Location Address
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Address Line | 1755 HERITAGE TRL SUITE 604, UNIT A
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City | NAPLES
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State | FL
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Zip | 34112-7600
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Country | US
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Telephone | 239-353-4101
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Fax | 239-353-4231
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Provider Business Mailing Address
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Address Line | 1454 MADISON AVE W
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City | IMMOKALEE
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State | FL
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Zip | 34142-2200
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Country | US
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Telephone | 239-353-4101
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Fax | 239-353-4231
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS003486L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS11273
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License Number State | FL
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