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General NPI Number Information
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NPI Number | 1265168090
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Entity Type | Organization
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Legal Business Name | FIRST COAST TMS, PLLC
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Dates
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Enumeration Date | 07/25/2022
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 8825 PERIMETER PARK BLVD STE 402
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1124
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Country | US
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Telephone | 904-647-6238
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Fax | 904-490-9035
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Provider Business Mailing Address
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Address Line | PO BOX 17726
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City | JACKSONVILLE
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State | FL
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Zip | 32245-7726
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Country | US
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Telephone | 904-647-6238
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Fax | 904-647-0898
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER D GAMMARANO
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Credential |
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Telephone | 904-647-6238
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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