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General NPI Number Information
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NPI Number | 1285991703
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Entity Type | Individual
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Provider Name | CATHERINE JEAN BLASSER D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/22/2012
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1350 HICKORY ST
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City | MELBOURNE
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State | FL
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Zip | 32901-3224
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Country | US
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Telephone | 321-434-1771
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Fax |
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Provider Business Mailing Address
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Address Line | 45TH MEDICAL GROUP 1381 SOUTH PATRICK DR
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City | PATRICK AFB
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State | FL
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Zip | 32925
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Country | US
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Telephone | 321-494-8241
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS21383
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 34.013196
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 34.013196
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 34.013196
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | OS21383
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License Number State | FL
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