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1912524091
BENET FANFAN
LAKE WORTH, FL
NPI
1912524091
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: FL 11007924)
Enumeration Date
2020-07-06
Last Update Date
2020-07-06
Business Address
BENET FANFAN
5941 STRAWBERRY LAKES CIR
LAKE WORTH, FL 33463-6507
Phone number: 561-568-5728
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Mailing Address
BENET FANFAN
5941 STRAWBERRY LAKES CIR
LAKE WORTH, FL 33463-6507
Phone number: 561-568-5728
Copy
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