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General NPI Number Information
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NPI Number | 1558587162
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Entity Type | Individual
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Provider Name | MICHAEL J CHICCONE DC
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 05/04/2009
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Provider Practice Location Address
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Address Line | 1030 S STATE ROAD 7
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City | PLANTATION
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State | FL
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Zip | 33317-4525
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Country | US
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Telephone | 954-581-3333
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Fax | 954-316-4666
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Provider Business Mailing Address
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Address Line | 2141 SW 120TH TER
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City | DAVIE
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State | FL
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Zip | 33325-5209
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Country | US
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Telephone | 954-370-7933
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Fax | 954-316-4666
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 6258
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | CH 6258
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License Number State | FL
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