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General NPI Number Information
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NPI Number | 1073504775
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Entity Type | Individual
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Provider Name | VESNA T MELANCON CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 1336 CREEKSIDE BLVD STE 1
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City | NAPLES
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State | FL
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Zip | 34108-1931
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Country | US
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Telephone | 239-261-1158
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Fax | 239-261-4232
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Provider Business Mailing Address
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Address Line | 9746 WILSHIRE LAKES BLVD
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City | NAPLES
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State | FL
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Zip | 34109-0752
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Country | US
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Telephone | 239-273-7074
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Fax | 239-261-4232
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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 | ARNP9192802
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License Number State | FL
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