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General NPI Number Information
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NPI Number | 1598870883
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Entity Type | Individual
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Provider Name | ANIBAL DE JESUS MD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 1900 DON WICKHAM DR STE 300
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City | CLERMONT
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State | FL
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Zip | 34711-1979
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Country | US
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Telephone | 352-394-4091
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Fax | 713-458-4229
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Provider Business Mailing Address
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Address Line | 15837 PENDIO DR
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City | BELLA COLLINA
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State | FL
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Zip | 34756-3649
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Country | US
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Telephone | 832-405-0546
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | K1177
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME139497
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License Number State | FL
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