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General NPI Number Information
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NPI Number | 1538092614
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Entity Type | Individual
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Provider Name | XAVIER DEON BRYANT JR. RN
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Gender | Male
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 1408 N KILLIAN DR, 208C
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City | LAKE PARK
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State | FL
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Zip | 33403
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Country | US
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Telephone | 561-662-2503
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 LAKE TERRY DR APT I
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-9287
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Country | US
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Telephone |
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9629579
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License Number State | FL
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