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General NPI Number Information
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NPI Number | 1194847871
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Entity Type | Individual
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Provider Name | ROMEO S. AMBROSIO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 02/06/2015
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Provider Practice Location Address
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Address Line | 601 S FLOYD ST SUITE 300
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City | LOUISVILLE
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State | KY
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Zip | 40202-1835
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Country | US
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Telephone | 502-629-1515
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Fax | 502-629-1545
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Provider Business Mailing Address
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Address Line | PO BOX 950202
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City | LOUISVILLE
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State | KY
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Zip | 40295-0202
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 01064174A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 41426
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License Number State | KY
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