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General NPI Number Information
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NPI Number | 1508368556
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Entity Type | Individual
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Provider Name | AMY RUZICKA OD
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Gender | Female
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 35 MIKE STEWART
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City | CRAWFORDVILLE
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State | FL
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Zip | 32327-1164
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Country | US
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Telephone | 850-270-5484
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Fax | 850-270-5484
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Provider Business Mailing Address
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Address Line | 35 MIKE STEWART
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City | CRAWFORDVILLE
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State | FL
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Zip | 32327-1164
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Country | US
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Telephone | 850-270-5484
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Fax | 850-270-5484
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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 | T3499
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003517
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA29554
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2098DT
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC5722
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License Number State | FL
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