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General NPI Number Information
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NPI Number | 1780649541
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Entity Type | Individual
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Provider Name | DELVIS A CELDRAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 11/13/2008
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Provider Practice Location Address
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Address Line | 543 NW LAKE WHITNEY PL UNIT 105
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-1604
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Country | US
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Telephone | 772-335-3255
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Fax | 772-335-3256
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Provider Business Mailing Address
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Address Line | PO BOX 882229
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34988-2229
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Country | US
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Telephone | 772-335-3255
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Fax | 772-335-3256
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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 | ME 95150
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License Number State | FL
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