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General NPI Number Information
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NPI Number | 1548431422
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Entity Type | Organization
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Legal Business Name | ASCENT CYBERKNIFE LLC
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 2111 SE OCEAN BLVD
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City | STUART
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State | FL
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Zip | 34996-3305
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Country | US
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Telephone | 772-223-9130
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Fax | 772-223-9120
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Provider Business Mailing Address
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Address Line | 2100 SE OCEAN BLVD SUITE 102
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City | STUART
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State | FL
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Zip | 34996-3332
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Country | US
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Telephone | 772-223-9130
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Fax | 772-223-9120
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Authorized Official
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Title or Position | VP- OPERATIONS
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Name | MARK E RAINIS
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Credential |
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Telephone | 772-486-5127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number |
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License Number State |
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