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General NPI Number Information
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NPI Number | 1760993661
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Entity Type | Organization
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Legal Business Name | LIZETH DELGADO
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Dates
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Enumeration Date | 10/18/2017
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 2101 S PARROTT AVE
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City | OKEECHOBEE
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State | FL
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Zip | 34974-6160
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Country | US
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Telephone | 863-467-3897
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Fax |
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Provider Business Mailing Address
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Address Line | 250 KAWAIHAE ST APT 7A
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City | HONOLULU
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State | HI
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Zip | 96825-1900
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Country | US
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Telephone | 786-200-6722
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. LIZETH R DELGADO
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Credential | OD
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Telephone | 786-200-6722
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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 | OPC5267
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License Number State | FL
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