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General NPI Number Information
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NPI Number | 1306274063
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Entity Type | Individual
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Provider Name | MARK MONZONE PA
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Gender | Male
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 4571 COLONIAL BLVD SUITE 210
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City | FORT MYERS
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State | FL
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Zip | 33966-1156
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Country | US
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Telephone | 239-333-0772
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Fax | 239-244-2049
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD ATTN: PAYER CONTRACTING & RELATIONS DEPT.
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9107437
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License Number State | FL
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