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General NPI Number Information
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NPI Number | 1942502091
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Entity Type | Organization
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Legal Business Name | EDWARD L BOSHNICK OD PA
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 01/18/2011
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Provider Practice Location Address
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Address Line | 7800 SW 87TH AVE SUITE B-270
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City | MIAMI
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State | FL
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Zip | 33173-3570
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Country | US
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Telephone | 305-271-8206
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Fax | 305-271-8209
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Provider Business Mailing Address
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Address Line | 7800 SW 87TH AVE SUITE B-270
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City | MIAMI
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State | FL
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Zip | 33173-3570
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Country | US
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Telephone | 305-271-8206
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Fax | 305-271-8209
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. EDWARD L BOSHNICK
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Credential | OD
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Telephone | 305-271-8206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 909
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License Number State | FL
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