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General NPI Number Information
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NPI Number | 1942153317
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Entity Type | Individual
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Provider Name | LOUREN MAYH B TOBOSO
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Gender | Female
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 1420 E VENICE AVE
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City | VENICE
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State | FL
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Zip | 34292-3063
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Country | US
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Telephone | 941-269-2740
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Fax |
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Provider Business Mailing Address
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Address Line | 3490 GILLOT BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33981-1319
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Country | US
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Telephone |
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT34745
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License Number State | FL
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