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General NPI Number Information
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NPI Number | 1821931916
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Entity Type | Individual
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Provider Name | BEAU FORTIER DC
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Gender | Male
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 4302 DEL PRADO BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33904-7169
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Country | US
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Telephone | 239-470-1065
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Fax |
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Provider Business Mailing Address
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Address Line | 4727 MIRAGE BAY CIR UNIT 409
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City | FORT MYERS
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State | FL
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Zip | 33966-6626
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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 |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH15201
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License Number State | FL
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