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General NPI Number Information
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NPI Number | 1457722928
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Entity Type | Organization
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Legal Business Name | LOBAR MEDICAL PA
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 10/09/2015
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Provider Practice Location Address
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Address Line | 24044 INTEGRITY WAY
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City | SORRENTO
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State | FL
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Zip | 32776-9353
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Country | US
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Telephone | 352-735-3118
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Fax |
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Provider Business Mailing Address
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Address Line | 24044 INTEGRITY WAY
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City | SORRENTO
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State | FL
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Zip | 32776-9353
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Country | US
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Telephone | 352-735-3118
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRUCE LOBAR
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Credential | MD
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Telephone | 352-735-3118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | ME115085
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License Number State | FL
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