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General NPI Number Information
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NPI Number | 1679094916
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Entity Type | Organization
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Legal Business Name | BLESSINGS MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 06/27/2017
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Provider Practice Location Address
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Address Line | 418 SW 47TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33914-6506
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Country | US
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Telephone | 239-945-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 3527 KNOLLWOOD RD
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City | FORT MYERS
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State | FL
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Zip | 33919-6414
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Country | US
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Telephone | 239-707-4459
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KEITH A BAKER
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Credential | DO
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Telephone | 239-945-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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