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General NPI Number Information
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NPI Number | 1245732239
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Entity Type | Individual
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Provider Name | MICHELE GREENE VUOLO NP-C
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Gender | Female
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 7409 SKINNER RD
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City | PANAMA CITY
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State | FL
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Zip | 32404-9113
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Country | US
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Telephone | 850-867-3014
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Fax |
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Provider Business Mailing Address
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Address Line | 2460 OLD MOULTRIE RD STE 1
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-4198
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Country | US
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Telephone | 904-293-0299
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Fax | 904-293-0299
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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 | F02180320
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9338347
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License Number State | FL
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