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General NPI Number Information
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NPI Number | 1407856131
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Entity Type | Individual
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Provider Name | ROSEMARY DE ANGELIS LAIRD MD
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Gender | Female
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 7000 SPYGLASS CT STE 501
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City | VIERA
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State | FL
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Zip | 32940-8288
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Country | US
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Telephone | 321-247-7063
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Fax | 866-422-6264
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Provider Business Mailing Address
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Address Line | 7000 SPYGLASS CT STE 501S
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City | VIERA
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State | FL
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Zip | 32940-8288
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Country | US
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Telephone | 321-247-7063
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Fax | 866-422-6264
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME85100
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License Number State | FL
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