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General NPI Number Information
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NPI Number | 1689354862
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Entity Type | Individual
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Provider Name | ROBERT DAVID SANFILIPPO PH.D, LMHC, CTMH
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Gender | Male
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 505 SHADY PINE CT
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City | MINNEOLA
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State | FL
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Zip | 34715-5684
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Country | US
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Telephone | 407-673-3773
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2093
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City | MINNEOLA
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State | FL
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Zip | 34755-2093
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Country | US
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Telephone | 407-673-3773
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH1226
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License Number State | FL
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