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General NPI Number Information
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NPI Number | 1477707677
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Entity Type | Organization
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Legal Business Name | MUKESH H MEHTA MD
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 7145 MARINER BLVD
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City | SPRING HILL
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State | FL
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Zip | 34609-1048
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Country | US
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Telephone | 352-754-7222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12160
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City | BROOKSVILLE
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State | FL
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Zip | 34603-2160
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Country | US
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Telephone | 352-754-7222
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Fax | 352-754-7207
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Authorized Official
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Title or Position | PRESIDENT
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Name | MUKESH H MEHTA
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Credential | MD
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Telephone | 352-754-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME0064242
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License Number State | FL
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