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General NPI Number Information
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NPI Number | 1063711802
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Entity Type | Individual
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Provider Name | ILANA VENDRYES M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/18/2011
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 1005 JOE DIMAGGIO DR
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5402
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Country | US
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Telephone | 954-265-5324
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Fax |
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Provider Business Mailing Address
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Address Line | 901 45TH ST
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City | MANGONIA PARK
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State | FL
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Zip | 33407-2495
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Country | US
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Telephone | 800-437-2636
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Fax | 954-618-4116
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME129017
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License Number State | FL
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