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General NPI Number Information
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NPI Number | 1669113718
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Entity Type | Individual
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Provider Name | BRITTANY RASHANNE GUY BUNDY MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 3003 W DR MARTIN LUTHER KING JR BLVD
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City | TAMPA
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State | FL
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Zip | 33607-6307
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Country | US
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Telephone | 813-554-8126
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 568
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City | MARIETTA
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State | GA
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Zip | 30061-0568
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 104403
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License Number State | GA
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