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General NPI Number Information
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NPI Number | 1982890158
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Entity Type | Organization
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Legal Business Name | MATRIX PULMONARY, P.A.
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 2401 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-4933
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Country | US
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Telephone | 941-744-1336
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Fax | 941-746-3846
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Provider Business Mailing Address
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Address Line | 2401 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-4933
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Country | US
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Telephone | 941-744-1336
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Fax | 941-746-3846
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. AMY L LEWIS
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Credential | RN
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Telephone | 941-744-1336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | OS7555
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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