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NPI 1801052972

NPI 1801052972 : CHERYL PROTAS LMT : DELRAY BEACH, FL

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General NPI Number Information
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    NPI Number           |    1801052972
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    Entity Type          |    Individual 
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    Provider Name        |    CHERYL PROTAS LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/29/2008
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    Last Update Date     |    01/05/2011
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Provider Practice Location Address
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    Address Line         |    14823 CUMBERLAND DR APT 105M 
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    City                 |    DELRAY BEACH
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    State                |    FL
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    Zip                  |    33446-1320
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    Country              |    US
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    Telephone            |    561-455-4209
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    Fax                  |    561-455-2406
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Provider Business Mailing Address
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    Address Line         |    14823 CUMBERLAND DR APT 105M 
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    City                 |    DELRAY BEACH
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    State                |    FL
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    Zip                  |    33446-1320
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    Country              |    US
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    Telephone            |    561-455-4209
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    Fax                  |    561-455-2406
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    MA12102
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    License Number State |    FL
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