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General NPI Number Information
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NPI Number | 1194728592
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Entity Type | Individual
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Provider Name | FLORENCIO ABASOLO GOMEZ MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2000 N VILLAGE AVE STE 205
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1001
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Country | US
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Telephone | 516-593-7227
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Fax | 516-593-1197
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Provider Business Mailing Address
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Address Line | 360 E 72ND ST APT C2602
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City | NEW YORK
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State | NY
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Zip | 10021-4767
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Country | US
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Telephone | 212-517-4292
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Fax | 212-472-0511
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 113433
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License Number State | NY
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