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General NPI Number Information
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NPI Number | 1164917829
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Entity Type | Individual
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Provider Name | ODAY ATA ELMANASEER MD
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Gender | Male
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 555 W 8TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6552
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Country | US
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Telephone | 904-244-8846
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Fax |
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Provider Business Mailing Address
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Address Line | 555 W 8TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6552
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Country | US
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Telephone |
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME172540
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License Number State | FL
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