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General NPI Number Information
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NPI Number | 1164621314
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Entity Type | Individual
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Provider Name | HOANG T VU DO
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Gender | Male
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 440 SW PERIMETER GLN
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City | LAKE CITY
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State | FL
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Zip | 32025-0497
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Country | US
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Telephone | 386-719-9663
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Fax | 386-719-9662
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Provider Business Mailing Address
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Address Line | 440 SW PERIMETER GLN
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City | LAKE CITY
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State | FL
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Zip | 32025-0497
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Country | US
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Telephone | 386-719-9663
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Fax | 386-719-9662
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | OS11191
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License Number State | FL
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