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General NPI Number Information
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NPI Number | 1881883676
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Entity Type | Organization
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Legal Business Name | WEST FLORIDA EYE INC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 07/16/2009
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Provider Practice Location Address
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Address Line | 2814 LEE BLVD STE 3
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-1542
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Country | US
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Telephone | 239-303-2687
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Fax | 239-303-2688
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Provider Business Mailing Address
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Address Line | 2814 LEE BLVD STE 3
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-1542
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Country | US
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Telephone | 239-303-2687
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Fax | 239-303-2688
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Authorized Official
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Title or Position | PRESIDENT
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Name | HABIB AZIZI
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Credential | O.D.
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Telephone | 239-303-2687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | OPC 3682
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License Number State | FL
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