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General NPI Number Information
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NPI Number | 1497120513
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Entity Type | Organization
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Legal Business Name | ALPHA VECTOR LLC
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Dates
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Enumeration Date | 12/01/2015
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 5900 COLLEGE RD
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City | KEY WEST
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State | FL
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Zip | 33040-4342
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Country | US
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Telephone | 305-294-5531
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Fax |
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Provider Business Mailing Address
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Address Line | 2637 E ATLANTIC BLVD # 35722
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4939
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Country | US
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Telephone | 954-543-0237
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Fax | 877-763-2948
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. KIM VINER
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Credential | RN
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Telephone | 248-701-2317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME90584
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License Number State | FL
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