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General NPI Number Information
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NPI Number | 1407666944
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Entity Type | Individual
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Provider Name | YASHIRA MARIE GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 733 S GOLDENROD RD SUITE A
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City | ORLANDO
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State | FL
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Zip | 32822-8100
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Country | US
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Telephone | 407-783-6273
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Fax |
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Provider Business Mailing Address
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Address Line | 3437 CIMARRON DR
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City | ORLANDO
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State | FL
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Zip | 32829-8522
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Country | US
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Telephone | 407-783-6273
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN5244460
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License Number State | FL
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