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General NPI Number Information
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NPI Number | 1487553558
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Entity Type | Individual
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Provider Name | LACY BORKSON
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Gender | Female
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 7340 NW 5TH ST
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City | PLANTATION
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State | FL
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Zip | 33317-1605
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Country | US
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Telephone | 786-259-0300
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Fax | 866-665-8671
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Provider Business Mailing Address
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Address Line | 15751 SHERIDAN ST # 303
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City | FT LAUDERDALE
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State | FL
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Zip | 33331-3486
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Country | US
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Telephone | 786-259-0300
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Fax | 866-665-8671
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT27617
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License Number State | FL
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