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General NPI Number Information
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NPI Number | 1811773690
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Entity Type | Individual
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Provider Name | ISMAEL JOEL SEMIDEY DC
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Gender | Male
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 521 N KIRKMAN RD # 130
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City | ORLANDO
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State | FL
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Zip | 32808-7644
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Country | US
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Telephone | 407-440-4658
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 FLORAL SPRINGS BLVD UNIT 29307
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City | PORT ORANGE
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State | FL
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Zip | 32129-6854
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Country | US
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Telephone | 787-673-2889
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH14634
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License Number State | FL
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