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General NPI Number Information
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NPI Number | 1245027622
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Entity Type | Individual
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Provider Name | MOHAMMED ABDUL MUQUITH
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Gender | Male
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 96031 VICTORIAS PL UNIT 111
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City | YULEE
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State | FL
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Zip | 32097-8633
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Country | US
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Telephone | 904-367-3372
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Fax |
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Provider Business Mailing Address
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Address Line | 4815 SWEETGRASS PL UNIT 201
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0131
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11038132
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 242664
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License Number State | LA
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