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Individual
LARRY KINCEL
Active
Individual
LARRY KINCEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS17574
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS17574
LICENSE NUMBER
FL
Enumeration date
01/22/2007
Last updated
07/08/2007
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