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General NPI Number Information
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NPI Number | 1265395669
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Entity Type | Individual
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Provider Name | MR. XAVIER DURAN CHARLES
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Gender | Male
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 7207 & 7225 NORTH NEBRASKA AVE
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City | TAMPA
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State | FL
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Zip | 33604
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Country | US
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Telephone | 813-236-1182
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Fax |
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Provider Business Mailing Address
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Address Line | 3440 SANTA RITA LN
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City | LAND O LAKES
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State | FL
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Zip | 34639-9002
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Country | US
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Telephone | 813-770-7717
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 22584
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License Number State | FL
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