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General NPI Number Information
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NPI Number | 1326451774
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Entity Type | Individual
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Provider Name | SARA LEILA CHALIFOUX MD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 1852 HILLVIEW ST STE 301
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City | SARASOTA
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State | FL
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Zip | 34239-3638
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Country | US
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Telephone | 941-262-0400
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Fax | 941-262-0410
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Provider Business Mailing Address
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Address Line | PO BOX 947407
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City | ATLANTA
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State | GA
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Zip | 30394-7407
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Country | US
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Telephone | 941-917-2600
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Fax | 941-917-7884
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME154101
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A142795
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License Number State | CA
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