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General NPI Number Information
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NPI Number | 1508862491
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Entity Type | Individual
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Provider Name | SILAS J CHARLES M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 1430 S PINE ST
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City | MELBOURNE
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State | FL
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Zip | 32901-3119
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Country | US
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Telephone | 321-952-0898
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 VILLA ESPANA TRL
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City | MELBOURNE
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State | FL
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Zip | 32935-4623
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Country | US
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Telephone |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0036401
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | ME36401
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License Number State | FL
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