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General NPI Number Information
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NPI Number | 1841069226
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Entity Type | Individual
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Provider Name | LEGRAND MARSEILLE
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Gender | Male
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Dates
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Enumeration Date | 12/27/2023
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 1309 N FLAGLER DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-3406
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Country | US
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Telephone | 561-655-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 3956 VICTORIA DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-4928
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Country | US
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Telephone | 561-452-5759
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number |
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License Number State |
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