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General NPI Number Information
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NPI Number | 1235363425
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Entity Type | Organization
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Legal Business Name | SARAH WILLARD MD PA
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Dates
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Enumeration Date | 05/04/2009
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Last Update Date | 05/04/2009
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Provider Practice Location Address
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Address Line | 1802 BELLEVUE AVE SUITE 101
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City | ORLANDO
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State | FL
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Zip | 32806-2933
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Country | US
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Telephone | 407-425-5537
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Fax | 407-426-0576
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Provider Business Mailing Address
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Address Line | PO BOX 568906
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City | ORLANDO
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State | FL
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Zip | 32856-8906
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Country | US
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Telephone | 407-425-5587
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Fax | 407-426-0567
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Authorized Official
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Title or Position | MD
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Name | DR. SARAH CAMP WILLARD
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Credential | MD
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Telephone | 407-425-5587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME71364
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License Number State | FL
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