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General NPI Number Information
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NPI Number | 1265728075
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Entity Type | Individual
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Provider Name | BONITA D RAMBO CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/21/2011
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 3710 LAKE CENTER DR
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City | MOUNT DORA
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State | FL
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Zip | 32757-2316
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Country | US
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Telephone | 352-383-1268
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 850001 DEPT #0753
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City | ORLANDO
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State | FL
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Zip | 32885-0753
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Country | US
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Telephone | 352-259-3814
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP3115212
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License Number State | FL
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