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General NPI Number Information
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NPI Number | 1679174775
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Entity Type | Individual
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Provider Name | RENEE JEFFREYS HEIL PHD
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Gender | Female
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 15971 MCGREGOR BLVD
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City | FORT MYERS
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State | FL
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Zip | 33908-2552
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Country | US
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Telephone | 801-896-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 161 HIBISCUS DR
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City | FORT MYERS BEACH
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State | FL
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Zip | 33931-3831
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Country | US
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Telephone | 859-816-1124
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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 | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number | 788281
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License Number State | IN
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