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General NPI Number Information
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NPI Number | 1801742887
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Entity Type | Organization
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Legal Business Name | MEDFAST DME SOLUTION LLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 11920 MYRTLE ROCK DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-3142
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Country | US
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Telephone | 631-784-3202
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Fax |
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Provider Business Mailing Address
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Address Line | 11920 MYRTLE ROCK DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-3142
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROXON KIMBERLY OSBOURNE
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Credential |
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Telephone | 631-784-3202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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