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General NPI Number Information
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NPI Number | 1023409984
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Entity Type | Individual
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Provider Name | LUCIOL D LIVETTE MD
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Gender | Female
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 109 N DOVERPLUM AVE
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City | KISSIMMEE
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State | FL
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Zip | 34758-3309
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Country | US
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Telephone | 407-943-8600
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Fax | 833-464-3641
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Provider Business Mailing Address
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Address Line | 1877 FORTUNE RD
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City | KISSIMMEE
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State | FL
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Zip | 34744-4428
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Country | US
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Telephone | 407-943-8600
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 19121
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1565
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License Number State | FL
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