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General NPI Number Information
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NPI Number | 1144303009
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Entity Type | Individual
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Provider Name | JOHN PAUL MINNI D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 2601 S KANNER HWY
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City | STUART
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State | FL
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Zip | 34994-4622
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Country | US
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Telephone | 772-219-2777
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Fax | 772-219-0017
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Provider Business Mailing Address
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Address Line | 1400 SE GOLDTREE DRIVE SUITE A-7
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City | PORT ST. LUCIE
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State | FL
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Zip | 34952
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Country | US
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Telephone | 772-335-3550
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Fax | 772-237-8013
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS8747
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | OS8747
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License Number State | FL
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