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General NPI Number Information
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NPI Number | 1831803121
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Entity Type | Organization
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Legal Business Name | INTREPID FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 1411 N FLAGLER DR STE 8200
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-3413
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Country | US
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Telephone | 561-612-3200
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Fax | 561-335-5424
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Provider Business Mailing Address
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Address Line | 1411 N FLAGLER DR STE 8200
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-3413
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Country | US
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Telephone | 561-612-3200
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Fax | 561-335-5424
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Authorized Official
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Title or Position | CEO
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Name | DR. DONALD LEVEILLE
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Credential | MD
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Telephone | 561-612-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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