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General NPI Number Information
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NPI Number | 1194234708
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Entity Type | Individual
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Provider Name | CHERYL RENEE MATCHETT
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Gender | Female
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 831 MAPLE CT
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City | MAITLAND
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State | FL
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Zip | 32751-6356
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Country | US
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Telephone | 407-421-6505
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Fax | 407-421-6505
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Provider Business Mailing Address
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Address Line | 831 MAPLE CT
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City | MAITLAND
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State | FL
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Zip | 32751-6356
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Country | US
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Telephone | 407-421-6505
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Fax | 407-628-4943
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number | 233855
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License Number State | FL
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