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General NPI Number Information
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NPI Number | 1609464189
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Entity Type | Organization
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Legal Business Name | WFW, LLC
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Dates
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Enumeration Date | 01/09/2021
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 12924 SW 103RD CT
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City | MIAMI
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State | FL
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Zip | 33176-5532
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Country | US
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Telephone | 786-543-3964
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 NE 41ST TER STE 354
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City | HOMESTEAD
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State | FL
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Zip | 33033-6619
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Country | US
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Telephone | 786-543-3964
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Fax | 786-255-7938
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JOANNA SANTA ANA
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Credential |
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Telephone | 786-543-3964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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