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General NPI Number Information
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NPI Number | 1487645974
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Entity Type | Individual
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Provider Name | ANDREW JOSEPH CIAMBRONE OD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 4444 W VINE ST
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City | KISSIMMEE
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State | FL
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Zip | 34746-5315
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Country | US
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Telephone | 407-390-0585
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Fax | 407-397-9231
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Provider Business Mailing Address
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Address Line | 3841 STRAFFORD PL
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City | LAKELAND
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State | FL
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Zip | 33810-2471
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Country | US
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Telephone | 863-670-0109
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Fax | 407-397-9231
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC003324
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License Number State | FL
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