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General NPI Number Information
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NPI Number | 1689660367
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Entity Type | Individual
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Provider Name | IHOR PIDHORECKY MD
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 7630 SW 34TH MNR STE 450
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City | DAVIE
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State | FL
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Zip | 33328-1987
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Country | US
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Telephone | 954-372-1429
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Fax | 954-744-4519
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Provider Business Mailing Address
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Address Line | 2301 N UNIVERSITY DR STE 204
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3617
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Country | US
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Telephone | 954-372-1429
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Fax | 954-744-4519
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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 | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | ME80863
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License Number State | FL
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