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General NPI Number Information
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NPI Number | 1457636995
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Entity Type | Individual
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Provider Name | NESTOR J MAISONET JIMENEZ MD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 1431 SW 1ST AVE
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City | OCALA
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State | FL
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Zip | 34471-6500
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Country | US
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Telephone | 352-232-4170
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Fax |
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Provider Business Mailing Address
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Address Line | 7079 TOLEDO RD
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City | SPRING HILL
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State | FL
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Zip | 34606-6170
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Country | US
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Telephone | 352-232-4170
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME154464
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME154464
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License Number State | FL
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