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General NPI Number Information
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NPI Number | 1043207640
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Entity Type | Organization
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Legal Business Name | MICHAEL JON RINALDI DO PA
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 06/26/2019
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Provider Practice Location Address
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Address Line | 150 E REDSTONE AVE SUITE B
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City | CRESTVIEW
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State | FL
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Zip | 32539-5357
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Country | US
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Telephone | 850-983-7778
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Fax | 850-983-7785
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Provider Business Mailing Address
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Address Line | 5230 WILLING ST
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City | MILTON
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State | FL
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Zip | 32570-4971
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Country | US
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Telephone | 850-983-7778
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Fax | 850-983-7785
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL J RINALDI
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Credential | DO
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Telephone | 850-983-7778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | OS7850
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License Number State | FL
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