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General NPI Number Information
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NPI Number | 1558775452
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Entity Type | Individual
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Provider Name | JARRET MCCARTNEY
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Gender | Male
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 11375 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5409
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Country | US
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Telephone | 352-593-7148
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Fax | 352-688-7224
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Provider Business Mailing Address
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Address Line | 5395 FIRETHORN PT
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City | SPRING HILL
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State | FL
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Zip | 34609-9511
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Country | US
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Telephone | 352-593-7148
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Fax | 352-688-7224
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | AA206
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License Number State | FL
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