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General NPI Number Information
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NPI Number | 1497097349
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Entity Type | Individual
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Provider Name | JILL L VANCIL
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Gender | Female
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Dates
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Enumeration Date | 03/19/2013
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 9000 SOUTHSIDE BLVD BLDG 900
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0791
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Country | US
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Telephone | 904-732-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 349 CAROLINA JASMINE LN
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City | ST JOHNS
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State | FL
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Zip | 32259-4037
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Country | US
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Telephone | 850-225-2917
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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