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General NPI Number Information
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NPI Number | 1538592324
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Entity Type | Organization
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Legal Business Name | LAKEWOOD RANCH HOSPITALISTS INC
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 6400 EDGELAKE DR
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City | SARASOTA
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State | FL
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Zip | 34240-8813
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Country | US
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Telephone | 404-542-5420
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Fax |
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Provider Business Mailing Address
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Address Line | 11160 LOST CREEK TER APT #301
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City | BRADENTON
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State | FL
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Zip | 34211-9357
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Country | US
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Telephone | 404-542-5420
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PEJMAN FARHANG
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Credential | MD
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Telephone | 404-542-5420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME113400
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License Number State | FL
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