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General NPI Number Information
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NPI Number | 1598761843
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Entity Type | Individual
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Provider Name | PAUL ALLEN LEE CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 1431 SW 1ST AVE
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City | OCALA
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State | FL
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Zip | 34474-4000
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Country | US
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Telephone | 352-401-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 2816 NE 25TH ST
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City | OCALA
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State | FL
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Zip | 34470-3987
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Country | US
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Telephone | 352-622-6713
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 050161
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License Number State | NC
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