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General NPI Number Information
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NPI Number | 1821095530
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Entity Type | Individual
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Provider Name | LUCIA L CLOVER M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 13184 N 103RD DR
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City | SUN CITY
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State | AZ
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Zip | 85351-3038
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Country | US
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Telephone | 623-972-2902
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Fax | 623-972-2539
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Provider Business Mailing Address
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Address Line | 2160 COLONIAL BLVD ATTN: PAYER CONTRACTING & RELATIONS DEPT.
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City | FORT MYERS
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State | FL
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Zip | 33907-1410
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 24233
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License Number State | AZ
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