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General NPI Number Information
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NPI Number | 1134117575
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Entity Type | Organization
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Legal Business Name | ST VINCENTS MEDICAL CENTER INC
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 1 SHIRCLIFF WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4748
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Country | US
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Telephone | 904-308-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 4205 BELFORT ROAD JAB # 4020
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City | JACKSONVILLE
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State | FL
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Zip | 32216
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Country | US
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Telephone | 904-450-6020
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Fax |
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Authorized Official
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Title or Position | COO SVHC/PRESIDENT SVR
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Name | DONNIE ROMINE
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Credential |
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Telephone | 904-308-1290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 4376
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License Number State | FL
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