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General NPI Number Information
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NPI Number | 1659446268
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Entity Type | Individual
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Provider Name | ANASTASIA CAMILLE JOBSON O. D.
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Gender | Female
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3001 N. STATE ROAD #7
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313
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Country | US
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Telephone | 954-497-0846
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Fax |
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Provider Business Mailing Address
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Address Line | 2961 NE 185TH ST #1601
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City | AVENTURA
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State | FL
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Zip | 33180-2938
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Country | US
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Telephone | 305-935-5067
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Fax | 954-733-2879
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 3904
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License Number State | FL
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