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General NPI Number Information
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NPI Number | 1235796400
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Entity Type | Individual
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Provider Name | GREGORY LEN REECE
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Gender | Male
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 9912 LITTLE RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34654-3419
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Country | US
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Telephone | 727-869-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 3042 STEPHANIE DR
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City | SPRING HILL
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State | FL
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Zip | 34608-4465
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Country | US
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Telephone | 850-585-7558
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Fax |
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 9380770
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License Number State | FL
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