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General NPI Number Information
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NPI Number | 1528716719
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Entity Type | Organization
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Legal Business Name | BIOFOURMIS CARE FL PLLC
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 1251 STAFFORD ST
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City | MONROE
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State | NC
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Zip | 28110-3349
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Country | US
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Telephone | 310-626-1049
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Fax |
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Provider Business Mailing Address
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Address Line | 33 ARCH ST
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City | BOSTON
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State | MA
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Zip | 02110-1424
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Country | US
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Telephone | 310-626-1049
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, PAYER CONTRACTING
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Name | DEVION SMITH
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Credential |
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Telephone | 424-326-8711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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