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General NPI Number Information
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NPI Number | 1477674372
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Entity Type | Organization
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Legal Business Name | CHARLES F HALFPENNY MD LLC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 12 NE 12TH AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33301-1604
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Country | US
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Telephone | 954-463-3416
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Fax | 954-523-5570
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Provider Business Mailing Address
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Address Line | 12 NE 12TH AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33301-1604
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Country | US
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Telephone | 954-463-3416
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Fax | 954-523-5570
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KATHERINE J MOLINET
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Credential |
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Telephone | 954-463-3416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202C00000X
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Taxonomy Name | Independent Medical Examiner Physician
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License Number | 0011163
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License Number State | FL
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