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General NPI Number Information
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NPI Number | 1730412586
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Entity Type | Organization
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Legal Business Name | ELBA E. MASID, MD, LLC
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 03/27/2013
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Provider Practice Location Address
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Address Line | 4513 OLD CANOE CREEK RD
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City | SAINT CLOUD
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State | FL
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Zip | 34769-1551
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Country | US
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Telephone | 407-498-0461
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Fax | 407-891-1353
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Provider Business Mailing Address
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Address Line | 4513 OLD CANOE CREEK RD
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City | SAINT CLOUD
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State | FL
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Zip | 34769-1551
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Country | US
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Telephone | 407-498-0461
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Fax | 407-891-1353
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELBA E MASID
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Credential | M.D.
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Telephone | 407-498-0461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME102282
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License Number State | FL
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