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General NPI Number Information
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NPI Number | 1760696207
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA EYE CARE LLC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 122 E CENTRAL AVE
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City | WINTER HAVEN
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State | FL
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Zip | 33880-6308
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Country | US
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Telephone | 863-294-2332
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Fax | 863-294-2334
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Provider Business Mailing Address
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Address Line | 813 KENILWORTH TER
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City | ORLANDO
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State | FL
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Zip | 32803-3902
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Country | US
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Telephone | 863-294-2332
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Fax | 863-294-2334
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. SCOTT EVAN KLEIN
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Credential | D.O.
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Telephone | 863-294-2332
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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 | OS-0006614
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License Number State | FL
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