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General NPI Number Information
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NPI Number | 1386721785
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Entity Type | Organization
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Legal Business Name | BAHMAN VENUS,M.D, P.A.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/22/2011
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Provider Practice Location Address
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Address Line | 3625 UNIVERSITY BLVD S
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4207
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Country | US
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Telephone | 904-399-6111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 863007
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City | ORLANDO
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State | FL
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Zip | 32886-3007
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Country | US
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Telephone | 904-396-5558
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Fax | 904-396-4279
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRUCE P KRIEGER
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Credential | M.D.
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Telephone | 904-399-6097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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