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General NPI Number Information
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NPI Number | 1497818561
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Entity Type | Individual
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Provider Name | EDWARD LESLIE BOSHNICK OD
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Gender | Male
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | 7800 SW 87TH AVE SUITE B-270
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City | MIAMI
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State | FL
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Zip | 33173-3570
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Country | US
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Telephone | 305-271-8206
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Fax | 305-271-8209
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Provider Business Mailing Address
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Address Line | 9960 SW 129 ST
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City | MIAMI
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State | FL
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Zip | 33176
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Country | US
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Telephone | 305-232-2093
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Fax | 305-233-3145
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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 | 909
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License Number State | FL
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