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NPI 1629175757

NPI 1629175757 : RONNIE WORD M.D. : FORT MYERS, FL

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General NPI Number Information
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    NPI Number           |    1629175757
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    Entity Type          |    Individual 
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    Provider Name        |    RONNIE WORD M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/20/2006
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    Last Update Date     |    07/02/2024
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Provider Practice Location Address
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    Address Line         |    12700 CREEKSIDE LN STE 301 
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    City                 |    FORT MYERS
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    State                |    FL
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    Zip                  |    33919-3356
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    Country              |    US
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    Telephone            |    239-343-3780
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    Fax                  |    239-343-3781
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Provider Business Mailing Address
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    Address Line         |    P.O. BOX 2147 
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    City                 |    FORT MYERS
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    State                |    FL
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    Zip                  |    33902-2147
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    Country              |    US
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    Telephone            |    239-343-9960
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    Fax                  |    239-424-4006
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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        |    2086S0129X
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    Taxonomy Name        |    Vascular Surgery Physician
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    License Number       |    ME77217
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    2086S0129X
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    Taxonomy Name        |    Vascular Surgery Physician
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    License Number       |    42900
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    License Number State |    WI
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