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General NPI Number Information
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NPI Number | 1083666325
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Entity Type | Individual
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Provider Name | GONZALO A ORIA MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 02/22/2020
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Provider Practice Location Address
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Address Line | 1696 SE HILLMOOR DR SUITE A
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7699
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Country | US
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Telephone | 772-337-4600
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Fax | 772-337-7600
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Provider Business Mailing Address
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Address Line | 1696 SE HILLMOOR DR STE B
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7699
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Country | US
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Telephone | 772-337-4600
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Fax | 772-337-7600
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME0045423
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License Number State | FL
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