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General NPI Number Information
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NPI Number | 1760629612
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Entity Type | Organization
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Legal Business Name | ADAMCIK MEDICAL INC
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 580 MALABAR RD SE SUITE 2
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City | PALM BAY
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State | FL
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Zip | 32907-3107
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Country | US
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Telephone | 321-327-2980
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Fax | 321-327-2982
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Provider Business Mailing Address
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Address Line | 580 MALABAR RD SE SUITE 2
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City | PALM BAY
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State | FL
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Zip | 32907-3107
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Country | US
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Telephone | 321-327-2980
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Fax | 321-327-2982
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAYMOND DOUGLAS ADAMCIK
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Credential | MD
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Telephone | 321-507-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME71737
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License Number State | FL
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