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General NPI Number Information
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NPI Number | 1063852192
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Entity Type | Individual
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Provider Name | EMILIO CLAUDIO CALABRESE MD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 2010 LEWIS TURNER BLVD
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547
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Country | US
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Telephone | 850-460-0052
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Fax | 844-341-2523
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Provider Business Mailing Address
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Address Line | 4516 E HIGHWAY 20 SUITE 226
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City | NICEVILLE
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State | FL
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Zip | 32578-9755
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Country | US
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Telephone | 305-934-9988
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME116123
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | CDR.0000125
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License Number State | CO
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