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General NPI Number Information
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NPI Number | 1720203854
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Entity Type | Individual
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Provider Name | PIERRE M LEROUX MD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 8745 N WICKHAM RD
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City | MELBOURNE
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State | FL
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Zip | 32940-5997
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Country | US
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Telephone | 321-434-9483
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Fax | 321-434-9482
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Provider Business Mailing Address
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Address Line | 1223 GATEWAY DR
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City | MELBOURNE
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State | FL
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Zip | 32901-2607
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Country | US
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Telephone | 321-725-4500
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Fax | 321-951-7408
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME100694
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME100694
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 063486
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License Number State | GA
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