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General NPI Number Information
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NPI Number | 1124029012
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Entity Type | Individual
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Provider Name | SALVATORE LACAGNINA D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 708 DEL PRADO BLVD S STE 2
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City | CAPE CORAL
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State | FL
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Zip | 33990-2676
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Country | US
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Telephone | 239-424-2120
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Fax | 239-424-4017
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Provider Business Mailing Address
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Address Line | 9371 CYPRESS LAKE DR STE 14
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City | FORT MYERS
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State | FL
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Zip | 33919-4995
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Country | US
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Telephone | 239-579-3800
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Fax | 239-766-8555
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS6586
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License Number State | FL
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