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General NPI Number Information
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NPI Number | 1285493551
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Entity Type | Individual
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Provider Name | PRIYAL ALKESH PATEL
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Gender | Female
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 644 CESERY BLVD STE 103
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City | JACKSONVILLE
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State | FL
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Zip | 32211-7165
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Country | US
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Telephone | 904-903-2755
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Fax | 904-903-2756
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Provider Business Mailing Address
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Address Line | 105 SOUTHPARK BLVD STE B201
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-5159
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Country | US
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Telephone | 904-824-1636
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Fax | 904-824-7488
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT41445
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License Number State | FL
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