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General NPI Number Information
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NPI Number | 1205819364
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Entity Type | Individual
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Provider Name | INDER K BHUTIANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 200 AVENUE F NE DEPT. OF RADIATION ONCOLOGY
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4131
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Country | US
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Telephone | 863-297-1865
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Fax | 863-291-6025
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Provider Business Mailing Address
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Address Line | 2715 WEST VIRGINIA AVENUE
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City | TAMPA
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State | FL
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Zip | 33607-6327
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Country | US
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Telephone | 813-662-6024
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Fax | 813-514-1257
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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 | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | ME42388
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | 144735-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | MD049357L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | D0024612
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License Number State | MD
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