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General NPI Number Information
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NPI Number | 1538126685
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Entity Type | Individual
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Provider Name | DONALD ROBERT ELTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 3480 POLYNESIAN ISLE BLVD
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City | KISSIMMEE
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State | FL
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Zip | 34746
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Country | US
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Telephone | 407-507-2615
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Fax | 407-507-2616
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Provider Business Mailing Address
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Address Line | 3480 POLYNESIAN ISLE BLVD SUITE 204
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City | KISSIMMEE
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State | FL
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Zip | 34746-1818
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Country | US
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Telephone | 407-507-2615
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Fax | 407-507-2616
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME62191
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 14158
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License Number State | SC
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