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General NPI Number Information
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NPI Number | 1528021557
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Entity Type | Individual
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Provider Name | EDGARDO FELICIANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 6239 LAKE WORTH RD
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City | GREENACRES
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State | FL
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Zip | 33463-3003
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Country | US
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Telephone | 561-812-1271
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Fax | 561-964-4050
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Provider Business Mailing Address
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Address Line | 6675 WESTWOOD BLVD STE 475
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City | ORLANDO
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State | FL
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Zip | 32821-6027
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Country | US
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Telephone | 407-845-0330
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Fax | 888-972-1752
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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 | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 11370
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME138722
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License Number State | FL
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