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General NPI Number Information
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NPI Number | 1679534366
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Entity Type | Individual
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Provider Name | EUGENE JONATHAN C. EUGENIO M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 483 N SEMORAN BLVD STE 104
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City | WINTER PARK
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State | FL
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Zip | 32792-3800
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Country | US
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Telephone | 321-436-0771
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Fax | 407-218-8906
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Provider Business Mailing Address
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Address Line | 2208 TERRANOVA CT
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City | LEXINGTON
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State | KY
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Zip | 40513-1839
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Country | US
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Telephone | 859-536-4189
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 37901
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License Number State | KY
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