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General NPI Number Information
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NPI Number | 1811034770
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Entity Type | Organization
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Legal Business Name | MEDICAL PROVIDERS INC.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 4450 SOUTH TAMIAMI TRAIL
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City | SARASOTA
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State | FL
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Zip | 34231-3454
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Country | US
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Telephone | 941-927-1234
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Fax | 941-921-0043
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Provider Business Mailing Address
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Address Line | 4450 S TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34231-3454
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Country | US
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Telephone | 941-927-1234
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Fax | 941-921-0043
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DONALD WILLIAM DONOVAN JR.
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Credential | P.A.-C
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Telephone | 941-927-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | PA1805
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License Number State | FL
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