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General NPI Number Information
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NPI Number | 1508163262
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA LUNG ASSOCIATES PLLC
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 08/18/2011
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Provider Practice Location Address
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Address Line | 13241 BARTRAM PARK BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5212
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Country | US
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Telephone | 904-290-1270
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Fax |
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Provider Business Mailing Address
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Address Line | 8200 HIGHGATE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1477
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Country | US
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Telephone | 904-412-3599
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RACHEL MOODEY
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Credential | MD
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Telephone | 904-290-1270
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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 | ME106024
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License Number State | FL
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