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General NPI Number Information
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NPI Number | 1285775130
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Entity Type | Individual
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Provider Name | LIVIO FEDERICO PARDI MD
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 203 LAKESHORE PT
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City | SAINT MARYS
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State | GA
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Zip | 31558-3843
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Country | US
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Telephone | 912-576-6465
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Fax |
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Provider Business Mailing Address
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Address Line | 2712 SE COUNTY ROAD 21B
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City | MELROSE
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State | FL
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Zip | 32666-5100
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Country | US
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Telephone | 912-576-6470
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | GA 038062
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License Number State | GA
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