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General NPI Number Information
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NPI Number | 1992214464
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA BACK SPINE AND SCOLIOSIS
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 15300 S JOG RD
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2162
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Country | US
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Telephone | 561-345-1780
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Fax | 561-214-4007
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Provider Business Mailing Address
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Address Line | 450 N FEDERAL HWY UNIT 611
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-4187
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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 | OWNER
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Name | MATTHEW HEPLER
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Credential |
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Telephone | 312-375-6337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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