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General NPI Number Information
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NPI Number | 1245867621
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Entity Type | Individual
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Provider Name | AMAL ALLOUDIN BHULLAR MD
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Gender | Female
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Dates
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Enumeration Date | 03/25/2020
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 580 W 8TH ST FL 322096TH
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6533
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Country | US
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Telephone | 904-244-3990
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Fax |
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Provider Business Mailing Address
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Address Line | 580 W 8TH STREET TOWER II, SUITE 6005
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City | JACKSONVILLE
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State | FL
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Zip | 32209
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Country | US
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Telephone | 904-244-3990
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME168264
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License Number State | FL
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