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General NPI Number Information
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NPI Number | 1437269446
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Entity Type | Organization
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Legal Business Name | WEST COAST EYE INSTITUTE PA
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 05/03/2011
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Provider Practice Location Address
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Address Line | 240 N LECANTO HWY
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City | LECANTO
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State | FL
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Zip | 34461-9191
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Country | US
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Telephone | 352-746-2246
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Fax | 352-746-2807
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Provider Business Mailing Address
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Address Line | 240 N LECANTO HWY
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City | LECANTO
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State | FL
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Zip | 34461-9191
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Country | US
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Telephone | 352-746-2246
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Fax | 352-746-2807
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN W ROWDA
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Credential | DO
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Telephone | 352-746-2246
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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 | OP1974
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME0060384
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OS0004322
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | OS0004322
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License Number State | FL
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