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General NPI Number Information
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NPI Number | 1417511957
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Entity Type | Individual
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Provider Name | VANICA MONAE GUIGNARD
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Gender | Female
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 2 TAMPA GENERAL CIRCLE
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City | ORLANDO
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State | FL
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Zip | 32891-1514
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Country | US
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Telephone | 813-821-8038
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Fax | 813-974-0483
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Provider Business Mailing Address
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Address Line | 6800 GEORGIA AVE NW APT 349
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City | WASHINGTON
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State | DC
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Zip | 20012-2676
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Country | US
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Telephone | 305-905-1988
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | D0094002
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | ME162980
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | MD210001975
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License Number State | DC
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