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General NPI Number Information
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NPI Number | 1598738288
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Entity Type | Individual
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Provider Name | DOMINIQUE C. DELTOR MD
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Gender | Female
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Dates
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Enumeration Date | 02/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7040 SEMINOLE PRATT WHITNEY RD STE 25-6
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-5714
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Country | US
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Telephone | 561-352-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 13527 49TH ST N
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-8142
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Country | US
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Telephone | 561-514-1570
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME86358
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License Number State | FL
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