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General NPI Number Information
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NPI Number | 1467721985
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Entity Type | Organization
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Legal Business Name | SUHAS JOSHI, MD PA
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 14346 BIG SPRING ST
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5167
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Country | US
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Telephone | 904-708-2542
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Fax | 904-619-5228
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Provider Business Mailing Address
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Address Line | 14346 BIG SPRING ST
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5167
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Country | US
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Telephone | 904-708-2542
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Fax | 904-619-5228
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Authorized Official
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Title or Position | OWNER
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Name | SUHAS VISHNU JOSHI
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Credential | MD
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Telephone | 904-708-2542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME73086
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License Number State | FL
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