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General NPI Number Information
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NPI Number | 1164585766
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Entity Type | Individual
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Provider Name | KEIVAN DEHGHANPISHEH PH. D. , M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 12955 PALMS WEST DR STE 203
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9217
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Country | US
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Telephone | 561-899-0762
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Fax | 833-217-6176
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Provider Business Mailing Address
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Address Line | 12955 PALMS WEST DR STE 203
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9217
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Country | US
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Telephone | 561-899-0762
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Fax | 833-217-6176
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | ME92999
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License Number State | FL
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