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General NPI Number Information
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NPI Number | 1114075801
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Entity Type | Individual
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Provider Name | RYAN V MESSINER D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/08/2016
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD #100371
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City | GAINESVILLE
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State | FL
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Zip | 32610-0371
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Country | US
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Telephone | 352-265-0301
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 SW ARCHER RD #100371
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City | GAINESVILLE
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State | FL
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Zip | 32610-0371
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Country | US
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Telephone | 352-265-0301
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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 | OS12136
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | OS12136
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License Number State | FL
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