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General NPI Number Information
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NPI Number | 1881096071
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Entity Type | Organization
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Legal Business Name | WILHELM C J LARSEN MD PA
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 04/18/2016
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Provider Practice Location Address
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Address Line | 351 POTTER RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-3621
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Country | US
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Telephone | 561-707-4161
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Fax | 561-908-2604
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Provider Business Mailing Address
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Address Line | PO BOX 220688 3900 HARVERHILL ROAD NORTH
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City | WEST PALM BEACH
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State | FL
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Zip | 33422-0688
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Country | US
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Telephone | 561-707-4161
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Fax | 561-791-2128
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | DR. WILHELM CHARLES JOSEPH LARSEN
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Credential | MD
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Telephone | 561-707-4161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | ME0027507
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | ME0027507
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License Number State | FL
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