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General NPI Number Information
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NPI Number | 1649516717
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Entity Type | Organization
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Legal Business Name | ORTHO FLORIDA LLC
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 7150 W 20TH AVE SUITE 209
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City | HIALEAH
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State | FL
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Zip | 33016-5529
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Country | US
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Telephone | 305-467-5678
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Fax | 305-503-7006
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Provider Business Mailing Address
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Address Line | 660 GLADES RD SUITE 460
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City | BOCA RATON
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State | FL
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Zip | 33431-6465
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Country | US
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Telephone | 561-300-1779
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JASON TOCCI
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Credential |
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Telephone | 954-410-5194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MDR-4545
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License Number State | HI
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