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General NPI Number Information
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NPI Number | 1003133455
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Entity Type | Organization
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Legal Business Name | NORTH PORT PRIMARY CARE ASSOCIATION PL
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 2500 BOBCAT VILLAGE CENTER RD UNIT E
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City | NORTH PORT
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State | FL
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Zip | 34288-8476
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Country | US
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Telephone | 941-429-4744
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Fax | 941-429-5754
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Provider Business Mailing Address
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Address Line | PO BOX 7825
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City | NORTH PORT
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State | FL
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Zip | 34290-0825
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Country | US
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Telephone | 941-429-4744
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Fax | 941-429-4754
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Authorized Official
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Title or Position | OWNER
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Name | GIRISH D PATEL
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Credential | MD
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Telephone | 941-429-4744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME95735
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License Number State | FL
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