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General NPI Number Information
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NPI Number | 1396726451
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Entity Type | Individual
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Provider Name | MARK D TRAN MD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 40100 HIGHWAY 27
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City | DAVENPORT
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State | FL
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Zip | 33837-5906
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Country | US
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Telephone | 863-422-4971
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Fax |
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Provider Business Mailing Address
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Address Line | 8390 CHAMPIONS GATE BLVD SUITE 306
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City | CHAMPIONS GATE
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State | FL
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Zip | 33896-8310
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Country | US
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Telephone | 407-390-1677
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Fax | 407-390-1765
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME90208
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License Number State | FL
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