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General NPI Number Information
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NPI Number | 1437155017
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Entity Type | Individual
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Provider Name | YOUSSEF KHALIL KHODOR DO
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Gender | Male
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 1907 HIGHWAY 44 W
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City | INVERNESS
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State | FL
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Zip | 34453-3801
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Country | US
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Telephone | 352-344-2273
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Fax | 352-344-2204
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Provider Business Mailing Address
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Address Line | PO BOX 2066
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City | LECANTO
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State | FL
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Zip | 34460-2066
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Country | US
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Telephone | 352-563-0931
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Fax | 352-563-0935
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS8274
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License Number State | FL
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