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General NPI Number Information
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NPI Number | 1972819944
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Entity Type | Individual
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Provider Name | ANTON MICAEL DELA CRUZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 1350 HICKORY ST
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City | MELBOURNE
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State | FL
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Zip | 32901-3224
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Country | US
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Telephone | 321-434-4225
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Fax |
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Provider Business Mailing Address
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Address Line | 10299 SOUTHERN BLVD UNIT 212773
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33421-5112
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Country | US
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Telephone | 860-389-8956
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Fax | 860-679-1621
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 229882
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License Number State | NC
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