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General NPI Number Information
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NPI Number | 1508036641
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Entity Type | Organization
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Legal Business Name | PATRICK H. GUADIZ, MD, PA
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 920 W COWBOY WAY
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City | LABELLE
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State | FL
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Zip | 33935
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Country | US
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Telephone | 863-675-2148
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Fax | 863-675-7078
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Provider Business Mailing Address
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Address Line | PO BOX 249
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City | LABELLE
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State | FL
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Zip | 33975-0249
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Country | US
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Telephone | 863-675-2148
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Fax | 863-675-7078
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PATRICK HERMY GUADIZ
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Credential | M.D.
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Telephone | 863-675-2148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME92599
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License Number State | FL
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