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General NPI Number Information
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NPI Number | 1356795140
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Entity Type | Individual
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Provider Name | RAPHAEL PARRADO M.D M.S
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Gender | Male
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 655 W 8TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6511
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Country | US
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Telephone | 904-244-3903
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Fax |
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Provider Business Mailing Address
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Address Line | 256 ASPEN LEAF DR
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City | PONTE VEDRA
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State | FL
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Zip | 32081-6033
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Country | US
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Telephone | 203-928-8462
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35144073
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | TP815
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 58454
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 169984
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License Number State | FL
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