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General NPI Number Information
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NPI Number | 1407532153
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Entity Type | Organization
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Legal Business Name | WESLEY CHAPEL VASCULAR LLC
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 2615 WINGUARD CIR UNIT 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544
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Country | US
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Telephone | 352-770-8346
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Fax |
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Provider Business Mailing Address
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Address Line | 2615 WINDGUARD CIR STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-7353
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SETH PURCELL
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Credential | MD
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Telephone | 801-472-3563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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