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General NPI Number Information
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NPI Number | 1205810421
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Entity Type | Individual
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Provider Name | GERALD J KIVETT MD
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Gender | Male
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 01/05/2010
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Provider Practice Location Address
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Address Line | 4711 CURRY FORD RD SUITE B
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City | ORLANDO
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State | FL
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Zip | 32812-2704
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Country | US
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Telephone | 407-275-9014
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Fax | 407-277-9249
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Provider Business Mailing Address
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Address Line | 4711 CURRY FORD RD SUITE B
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City | ORLANDO
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State | FL
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Zip | 32812-2704
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Country | US
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Telephone | 407-275-9014
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Fax | 407-277-9249
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME0037122
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License Number State | FL
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