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General NPI Number Information
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NPI Number | 1588107916
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Entity Type | Individual
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Provider Name | MR. SHAWN GIDARO
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Gender | Male
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Dates
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Enumeration Date | 12/03/2016
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 502 GUMWOOD CT
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2305
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Country | US
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Telephone | 321-444-8276
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Fax | 207-352-5341
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Provider Business Mailing Address
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Address Line | 502 GUMWOOD CT
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2305
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Country | US
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Telephone | 321-444-8276
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Fax | 207-352-5341
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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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 |
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License Number State | FL
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