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General NPI Number Information
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NPI Number | 1053401026
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Entity Type | Individual
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Provider Name | DAWN RENEE VERVILLE RRT
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 9800 S HEALTHPARK DR SUITE #205
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City | FORT MYERS
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State | FL
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Zip | 33908-7603
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Country | US
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Telephone | 239-985-3580
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Fax | 239-985-3589
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Provider Business Mailing Address
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Address Line | 9800 S HEALTHPARK DR SUITE #205
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City | FORT MYERS
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State | FL
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Zip | 33908-7603
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Country | US
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Telephone | 239-985-3580
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Fax | 239-985-3589
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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 | 2279P3900X
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Taxonomy Name | Neonatal/Pediatric Registered Respiratory Therapist
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License Number | RT 4246
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License Number State | FL
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