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General NPI Number Information
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NPI Number | 1467122259
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Entity Type | Individual
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Provider Name | NATALIA TRIKOZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 201 VILLAGE OAKS DR
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City | ST JOHNS
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State | FL
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Zip | 32259-3876
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Country | US
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Telephone | 904-240-0442
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Fax |
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Provider Business Mailing Address
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Address Line | 8283 BAYMEADOWS RD E APT 1201
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City | JACKSONVILLE
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State | FL
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Zip | 32256-3058
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Country | US
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Telephone | 603-557-5845
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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