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General NPI Number Information
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NPI Number | 1710549035
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Entity Type | Individual
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Provider Name | LOGAN ARBOGAST PA
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Gender | Male
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 7000 H C KELLEY RD
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City | ORLANDO
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State | FL
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Zip | 32831-2518
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Country | US
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Telephone | 407-207-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 890 E EAU GALLIE BLVD.
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City | INDIAN HARBOR
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State | FL
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Zip | 32937
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Country | US
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Telephone | 321-722-7295
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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