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General NPI Number Information
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NPI Number | 1760442057
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Entity Type | Individual
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Provider Name | RANDOLPH S GESLANI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 228 PLAZA DR SUITE E
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City | LEHIGH ACRES
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State | FL
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Zip | 33936-6054
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Country | US
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Telephone | 239-368-7260
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Fax | 239-694-5953
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Provider Business Mailing Address
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Address Line | PO BOX 51679
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City | FORT MYERS
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State | FL
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Zip | 33994-1679
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Country | US
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Telephone | 239-368-7260
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Fax | 239-694-5953
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 33246
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License Number State | FL
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Legacy Identifiers
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Identifier #1
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Identifier Code | 038996000
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Identifier Type | MEDICAID
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Identifier State | FL
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 038996000
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Identifier Type | MEDICAID
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Identifier State | FL
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Identifier Issuer |
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