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General NPI Number Information
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NPI Number | 1154758316
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Entity Type | Individual
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Provider Name | JONATHAN GOPEN
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Gender | Male
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 1110 CHAPEL HILLS DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3923
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Country | US
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Telephone | 978-882-1737
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Fax |
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Provider Business Mailing Address
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Address Line | 1506 SE 29TH ST
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City | CAPE CORAL
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State | FL
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Zip | 33904-3960
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Country | US
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Telephone | 978-882-1737
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1297
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT.0005773
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6558
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License Number State | MA
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