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General NPI Number Information
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NPI Number | 1245466986
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Entity Type | Organization
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Legal Business Name | GARY C CHIERICO MD PA
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Dates
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Enumeration Date | 06/09/2009
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Last Update Date | 06/23/2010
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Provider Practice Location Address
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Address Line | 1100 NW 95TH ST
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City | MIAMI
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State | FL
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Zip | 33150-2038
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Country | US
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Telephone | 305-785-7013
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 30250
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City | FORT LAUDERDALE
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State | FL
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Zip | 33303-0250
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Country | US
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Telephone | 305-785-7013
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY CHARLES CHIERICO
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Credential | M.D.
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Telephone | 305-785-7013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME0049242
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License Number State | FL
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