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General NPI Number Information
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NPI Number | 1346223229
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Entity Type | Individual
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Provider Name | CATHY L CRISS DO
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Gender | Female
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 19531 COCHRAN BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-2081
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Country | US
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Telephone | 941-255-3535
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Fax | 941-766-7999
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Provider Business Mailing Address
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Address Line | 3434 HANCOCK BRIDGE PKWY
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City | N FT MYERS
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State | FL
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Zip | 33903-7094
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Country | US
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Telephone | 877-856-3774
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Fax | 239-599-2625
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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 | OS0007162
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License Number State | FL
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