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General NPI Number Information
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NPI Number | 1275867335
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA PULMONARY ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 04/16/2013
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Provider Practice Location Address
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Address Line | 11512 LAKE MEAD AVE UNIT # 303
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City | JACKSONVILLE
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State | FL
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Zip | 32256-9680
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Country | US
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Telephone | 904-371-2756
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Fax | 904-900-3590
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Provider Business Mailing Address
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Address Line | 11512 LAKE MEAD AVE UNIT # 303
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City | JACKSONVILLE
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State | FL
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Zip | 32256-9680
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Country | US
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Telephone | 904-371-2756
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Fax | 904-900-3590
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Authorized Official
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Title or Position | MGRM
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Name | BASSEL RAMADAN
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Credential | MD
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Telephone | 904-371-2756
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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 | ME87777
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License Number State | FL
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