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General NPI Number Information
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NPI Number | 1588564389
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Entity Type | Individual
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Provider Name | MARINA ALEXANDRIA DOVENBERG DPT
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Gender | Female
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 425 W TOWN PL STE 102
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3662
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Country | US
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Telephone | 904-799-7883
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Fax |
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Provider Business Mailing Address
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Address Line | 14750 BEACH BLVD APT 37
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-2347
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Country | US
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Telephone | 786-897-3464
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT45671
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License Number State | FL
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