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General NPI Number Information
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NPI Number | 1922684331
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Entity Type | Individual
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Provider Name | KEVIN JOHN DO
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Gender | Male
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 2815 S SEACREST BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-7969
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Country | US
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Telephone | 561-955-6663
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 NW 13TH ST STE 201
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City | BOCA RATON
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State | FL
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Zip | 33486-2269
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Country | US
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Telephone | 561-955-6663
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Fax | 561-955-2879
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OS22329
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License Number State | FL
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