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General NPI Number Information
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NPI Number | 1023257177
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Entity Type | Individual
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Provider Name | JOSE VELOSO M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 01/20/2020
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Provider Practice Location Address
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Address Line | 6300 LA CALMA DR SUITE 200 C/O ESP
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City | AUSTIN
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State | TX
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Zip | 78752-3843
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Country | US
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Telephone | 815-382-4520
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Fax |
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Provider Business Mailing Address
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Address Line | 930 MISTLETOE DR
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City | LANTANA
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State | TX
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Zip | 76226-6980
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Country | US
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Telephone | 815-382-4520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 125054497
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | P1942
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License Number State | TX
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