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General NPI Number Information
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NPI Number | 1780686717
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Entity Type | Individual
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Provider Name | JAMES BEN RENFROE MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 400 GULF BREEZE PKWY STE 300
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City | GULF BREEZE
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State | FL
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Zip | 32561-4458
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Country | US
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Telephone | 850-932-5055
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Fax | 850-932-1401
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Provider Business Mailing Address
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Address Line | PO BOX 280
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City | GULF BREEZE
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State | FL
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Zip | 32562-0280
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Country | US
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Telephone | 850-932-5055
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Fax | 850-932-1404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | ME66614
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License Number State | FL
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