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General NPI Number Information
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NPI Number | 1336435643
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Entity Type | Individual
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Provider Name | SAMUEL FRANCIS LIVINGSTON II M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 10/07/2019
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Provider Practice Location Address
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Address Line | 3 SHIRCLIFF WAY STE 330
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4780
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Country | US
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Telephone | 904-384-7370
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Fax | 904-384-7851
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Provider Business Mailing Address
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Address Line | 4205 BELFORT RD STE 4015
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City | JACKSONVILLE
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State | FL
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Zip | 32216-3623
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME141051
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License Number State | FL
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