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General NPI Number Information
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NPI Number | 1578515359
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Entity Type | Individual
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Provider Name | CARMELO CEDRES MD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 6271 SAINT AUGUSTINE RD STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2555
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Country | US
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Telephone | 904-633-0460
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Fax | 904-633-0461
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Provider Business Mailing Address
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Address Line | PO BOX 44008
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City | JACKSONVILLE
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State | FL
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Zip | 32231-4008
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Country | US
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Telephone | 904-633-0460
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Fax | 904-633-0461
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C10008672
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | C10008672
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME53455
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License Number State | FL
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