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General NPI Number Information
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NPI Number | 1245680636
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Entity Type | Individual
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Provider Name | JASON MOHEL EPSTEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 2200 FOWLER GROVE BLVD STE 360
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5597
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Country | US
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Telephone | 407-853-5333
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Fax | 407-743-3050
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Provider Business Mailing Address
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Address Line | 833 CHESTNUT ST STE 520
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4430
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Country | US
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Telephone | 267-606-4478
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Fax | 267-339-3761
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | ME145463
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License Number State | FL
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