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General NPI Number Information
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NPI Number | 1366752552
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Entity Type | Organization
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Legal Business Name | JOANNE D SAXOUR MD
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 790 DUNLAWTON AVE SUITE G
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City | PORT ORANGE
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State | FL
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Zip | 32127-4222
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Country | US
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Telephone | 386-756-4488
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Fax | 386-788-2026
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Provider Business Mailing Address
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Address Line | 790 DUNLAWTON AVE SUITE G
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City | PORT ORANGE
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State | FL
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Zip | 32127-4222
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Country | US
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Telephone | 386-756-4488
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Fax | 386-788-2026
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | JOANNE D SAXOUR
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Credential | M.D.
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Telephone | 386-756-4488
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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 | ME83465
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License Number State | FL
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