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General NPI Number Information
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NPI Number | 1306073218
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Entity Type | Individual
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Provider Name | MICHAEL SIMONETTI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 11750 SW 40TH ST
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City | MIAMI
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State | FL
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Zip | 33175-3530
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Country | US
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Telephone | 305-227-5548
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Fax | 305-227-5556
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Provider Business Mailing Address
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Address Line | 1613 HARRISON PKWY SUITE 200
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City | SUNRISE
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State | FL
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Zip | 33323-2896
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Country | US
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Telephone | 954-838-2502
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Fax | 954-851-1758
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME104084
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License Number State | FL
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