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General NPI Number Information
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NPI Number | 1619636149
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Entity Type | Individual
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Provider Name | NATALIA VELAZQUEZ DHSC, PA-C, MS, CFMP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2021
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 1700 HOSPITAL SOUTH DR STE 404
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City | AUSTELL
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State | GA
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Zip | 30106-8116
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Country | US
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Telephone | 404-645-8271
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 307
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City | HARDEEVILLE
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State | SC
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Zip | 29927-0307
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Country | US
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Telephone | 404-645-8271
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 12981
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License Number State | GA
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