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NPI 1831260033

NPI 1831260033 : CAROL ARMSTRONG LOGAN O.D. : LAKE MARY, FL

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General NPI Number Information
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    NPI Number           |    1831260033
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    Entity Type          |    Individual 
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    Provider Name        |    CAROL ARMSTRONG LOGAN O.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/11/2006
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    Last Update Date     |    11/08/2007
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Provider Practice Location Address
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    Address Line         |    560 RINEHART RD SUITE 100
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    City                 |    LAKE MARY
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    State                |    FL
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    Zip                  |    32746-4897
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    Country              |    US
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    Telephone            |    407-333-7333
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    Fax                  |    407-333-7313
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Provider Business Mailing Address
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    Address Line         |    560 RINEHART RD SUITE 100
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    City                 |    LAKE MARY
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    State                |    FL
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    Zip                  |    32746-4897
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    Country              |    US
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    Telephone            |    407-333-7333
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    Fax                  |    407-333-7313
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    OPC2262
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    License Number State |    FL
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