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General NPI Number Information
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NPI Number | 1730978073
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Entity Type | Organization
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Legal Business Name | BRUNSWICK HOLDINGS LLC
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Dates
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Enumeration Date | 05/03/2025
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Last Update Date | 05/03/2025
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Provider Practice Location Address
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Address Line | 2415 TARPON BAY BLVD
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City | NAPLES
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State | FL
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Zip | 34119-8764
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Country | US
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Telephone | 239-206-1192
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Fax | 813-807-5256
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Provider Business Mailing Address
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Address Line | 27028 BELLE RIO DR
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4427
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Country | US
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Telephone | 239-206-1192
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. DANIEL HACHEY
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Credential | OD
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Telephone | 239-206-1192
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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 |
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License Number State |
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