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General NPI Number Information
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NPI Number | 1265451017
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Entity Type | Individual
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Provider Name | MONWARA HASSAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 2500 RHODE ISLAND AVE SUITE A
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City | FORT PIERCE
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State | FL
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Zip | 34947-4771
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Country | US
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Telephone | 772-489-4001
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Fax | 772-489-8411
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Provider Business Mailing Address
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Address Line | 2721 SE NORTH LOOKOUT BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34984-6108
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Country | US
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Telephone | 914-373-8198
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Fax | 772-489-8411
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 221851
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME119146
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License Number State | FL
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