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General NPI Number Information
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NPI Number | 1053746479
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Entity Type | Individual
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Provider Name | BRENTON DANIEL MCCOY D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 13644 WALSINGHAM RD
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City | LARGO
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State | FL
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Zip | 33774-3532
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Country | US
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Telephone | 727-595-2519
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Fax | 727-595-3872
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Provider Business Mailing Address
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Address Line | 13644 WALSINGHAM RD
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City | LARGO
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State | FL
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Zip | 33774-3532
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Country | US
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Telephone | 727-595-2519
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Fax | 727-595-3872
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | OS13291
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS13291
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License Number State | FL
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