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General NPI Number Information
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NPI Number | 1538476981
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Entity Type | Individual
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Provider Name | SNEHA MODI
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Gender | Female
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 04/22/2019
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Provider Practice Location Address
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Address Line | 820 PRUDENTIAL DR SUITE 304
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8210
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Country | US
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Telephone | 904-348-0974
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Fax | 904-348-5627
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Provider Business Mailing Address
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Address Line | 23343 NW COUNTY ROAD 236
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City | HIGH SPRINGS
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State | FL
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Zip | 32643-9669
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Country | US
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Telephone | 904-202-1032
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Fax | 904-376-4107
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 271892
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 271892
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME129435
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License Number State | FL
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