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General NPI Number Information
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NPI Number | 1851572549
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Entity Type | Organization
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Legal Business Name | MITCHELL POLLAK MD PA
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 8100 ROYAL PALM BLVD SUITE 105
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5733
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Country | US
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Telephone | 954-345-6789
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Fax | 954-345-7998
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Provider Business Mailing Address
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Address Line | 8100 ROYAL PALM BLVD SUITE 105
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5733
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Country | US
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Telephone | 954-345-6789
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Fax | 954-345-7998
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Authorized Official
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Title or Position | OWNER
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Name | DR. MITCHELL R. POLLAK
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Credential | M.D.
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Telephone | 954-345-6789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 00050840
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License Number State | FL
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