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General NPI Number Information
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NPI Number | 1760412456
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Entity Type | Organization
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Legal Business Name | DELROWE EYE CARE, PA
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 1715 SE TIFFANY AVE
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7520
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Country | US
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Telephone | 772-337-2020
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Fax | 772-337-1704
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Provider Business Mailing Address
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Address Line | PO BOX 9077
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City | PORT ST LUCIE
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State | FL
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Zip | 34985-9077
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Country | US
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Telephone | 772-337-2020
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Fax | 772-337-1704
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL J DELROWE
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Credential | M.D.
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Telephone | 772-337-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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