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General NPI Number Information
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NPI Number | 1932533353
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Entity Type | Organization
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Legal Business Name | MEDPLUS MEDICAL CENTER, INC
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Dates
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Enumeration Date | 08/22/2013
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 2887 LAKE WORTH RD
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City | LAKE WORTH
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State | FL
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Zip | 33461-4127
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Country | US
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Telephone | 305-748-9310
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Fax |
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Provider Business Mailing Address
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Address Line | 2887 LAKE WORTH RD
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City | LAKE WORTH
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State | FL
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Zip | 33461-4127
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Country | US
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Telephone | 305-748-9310
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | DONNA MEDOR
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Credential |
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Telephone | 305-748-9310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | FL
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