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General NPI Number Information
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NPI Number | 1265992002
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Entity Type | Individual
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Provider Name | ALEXANDER THOMAS NOWICKI MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 1110 GULF BREEZE PKWY
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City | GULF BREEZE
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State | FL
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Zip | 32561-4884
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Country | US
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Telephone | 850-469-2044
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Fax | 850-434-4683
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Provider Business Mailing Address
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Address Line | PO BOX 919374
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City | ORLANDO
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State | FL
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Zip | 32891-9374
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Country | US
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Telephone | 866-863-2540
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME170918
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License Number State | FL
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