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General NPI Number Information
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NPI Number | 1891950663
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER WEST PALM BEACH
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 7305 N MILITARY TRL
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City | RIVIERA BEACH
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State | FL
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Zip | 33410-7417
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Country | US
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Telephone | 561-422-6489
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Fax | 561-422-5678
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Provider Business Mailing Address
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Address Line | 7305 N MILITARY TRL
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City | RIVIERA BEACH
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State | FL
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Zip | 33410-7417
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Country | US
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Telephone | 561-422-6489
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Fax | 561-422-5678
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Authorized Official
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Title or Position | STAFF NURSE
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Name | MRS. KAREN M. RUSSO
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Credential | RN
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Telephone | 561-422-6489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | 1266042
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License Number State | FL
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