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General NPI Number Information
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NPI Number | 1639119837
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Entity Type | Individual
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Provider Name | STEPHEN ALLEN GOLDMAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 6633 FOREST AVE 302
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-2612
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Country | US
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Telephone | 727-849-8771
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Fax | 727-842-4962
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Provider Business Mailing Address
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Address Line | 14100 FIVAY ROAD SUITE 110
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City | HUDSON
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State | FL
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Zip | 34667-7159
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Country | US
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Telephone | 727-849-8771
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Fax | 727-842-4962
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME33564
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License Number State | FL
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