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General NPI Number Information
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NPI Number | 1518022953
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Entity Type | Individual
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Provider Name | JOHN A WHITE M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 923 DEL PRADO BLVD
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City | CAPE CORAL
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State | FL
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Zip | 33990-3652
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Country | US
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Telephone | 239-458-5452
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Fax |
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Provider Business Mailing Address
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Address Line | 4551 RANDAG DR
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-4731
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Country | US
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Telephone | 239-656-6406
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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 | ME33138
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License Number State | FL
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