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General NPI Number Information
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NPI Number | 1801461892
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Entity Type | Individual
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Provider Name | KAMI LYN ADORACION HATLEY CSFA, CST
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Gender | Female
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Dates
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Enumeration Date | 05/23/2021
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 36468 EMERALD COAST PARKWAY STE 1101
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City | DESTIN
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State | FL
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Zip | 32541
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Country | US
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Telephone | 901-486-9414
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Fax |
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Provider Business Mailing Address
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Address Line | 19211 PANAMA CITY BEACH PKWY #1030
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32413-8712
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Country | US
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Telephone | 901-486-9414
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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