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General NPI Number Information
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NPI Number | 1841564002
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Entity Type | Organization
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Legal Business Name | FIORE CHIROPRACTIC OFFICE
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 637 BLANDING BLVD STE 3
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City | ORANGE PARK
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State | FL
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Zip | 32073-5029
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Country | US
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Telephone | 904-276-5433
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Fax | 904-272-5546
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Provider Business Mailing Address
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Address Line | 637 BLANDING BLVD STE 3
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City | ORANGE PARK
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State | FL
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Zip | 32073-5029
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Country | US
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Telephone | 904-276-5433
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Fax | 904-272-5546
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY J FIORE
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Credential | MD
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Telephone | 904-276-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 4727
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License Number State | FL
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