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General NPI Number Information
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NPI Number | 1205817814
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Entity Type | Individual
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Provider Name | RAVI SHARMA M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 7767 S SUNCOAST BLVD
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City | HOMOSASSA
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State | FL
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Zip | 34446-5004
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Country | US
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Telephone | 352-621-0777
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Fax | 352-382-2491
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Provider Business Mailing Address
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Address Line | 7767 S SUNCOAST BLVD
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City | HOMOSASSA
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State | FL
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Zip | 34446-5004
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Country | US
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Telephone | 352-621-0777
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Fax | 352-382-2491
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME78774
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License Number State | FL
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