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General NPI Number Information
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NPI Number | 1760463053
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Entity Type | Individual
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Provider Name | JUSTINO SILVESTRE MD
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Gender | Male
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 3524 TAMIAMI TRL SUITE D
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8100
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Country | US
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Telephone | 941-255-9815
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Fax | 941-255-9831
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Provider Business Mailing Address
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Address Line | PO BOX 495550
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City | PORT CHARLOTTE
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State | FL
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Zip | 33949-5550
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Country | US
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Telephone | 941-255-9815
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Fax | 941-255-9831
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME67570
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License Number State | FL
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