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General NPI Number Information
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NPI Number | 1164560124
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Entity Type | Organization
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Legal Business Name | WEST FLORIDA MEDICAL ASSOCIATES P A
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 10/12/2010
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Provider Practice Location Address
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Address Line | 2669 N FLORIDA AVE
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City | HERNANDO
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State | FL
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Zip | 34442
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Country | US
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Telephone | 352-637-2550
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Fax | 352-637-2551
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Provider Business Mailing Address
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Address Line | PO BOX 640573
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City | BEVERLY HILLS
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State | FL
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Zip | 34464-0573
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Country | US
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Telephone | 352-746-1558
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Fax | 352-746-3838
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SHIRISHKUMAR G PATEL
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Credential | MD
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Telephone | 352-637-2550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | ME0050533
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License Number State | FL
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