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General NPI Number Information
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NPI Number | 1245248509
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Entity Type | Individual
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Provider Name | SALVATORE MARK CARIDI D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 551 NATIONAL HEALTH CARE DR
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-1495
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Country | US
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Telephone | 386-323-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 27 SOUTHERN PINE TRL
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5988
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Country | US
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Telephone | 386-673-3622
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 5958
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License Number State | FL
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