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General NPI Number Information
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NPI Number | 1598995185
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Entity Type | Individual
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Provider Name | VIKASH PRIYADARSHI MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 336 COGAN DR SE
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City | PALM BAY
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State | FL
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Zip | 32909-6869
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Country | US
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Telephone | 321-460-4001
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Fax | 321-622-6400
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Provider Business Mailing Address
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Address Line | PO BOX 361095
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City | MELBOURNE
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State | FL
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Zip | 32936-1095
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Country | US
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Telephone | 321-462-4001
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Fax | 321-622-6400
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME111767
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License Number State | FL
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