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General NPI Number Information
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NPI Number | 1528589926
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Entity Type | Organization
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Legal Business Name | DOCTORS CARE BHRT AND VITAMIN CENTER LLC
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10051 LORRAINE RD STE B
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City | GULFPORT
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State | MS
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Zip | 39503-6001
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Country | US
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Telephone | 228-604-4546
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Fax | 228-604-4540
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Provider Business Mailing Address
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Address Line | 10051 LORRAINE RD STE B
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City | GULFPORT
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State | MS
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Zip | 39503-6001
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Country | US
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Telephone | 228-604-4546
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Fax | 228-604-4540
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. JOHN BAZZONE
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Credential | OFFICE MANAGER
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Telephone | 727-424-5780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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