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General NPI Number Information
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NPI Number | 1669751855
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Entity Type | Individual
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Provider Name | TINA FABIANO DO
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Gender | Female
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Dates
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Enumeration Date | 08/05/2011
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Last Update Date | 05/17/2025
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Provider Practice Location Address
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Address Line | 1901 S CONGRESS AVE STE 420
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-6588
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Country | US
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Telephone | 561-364-1479
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Fax |
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Provider Business Mailing Address
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Address Line | 3050 SAINT JAMES DR
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City | BOCA RATON
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State | FL
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Zip | 33434-3369
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Country | US
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Telephone | 847-308-2975
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036.134175
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | OS14846
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License Number State | FL
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