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General NPI Number Information
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NPI Number | 1821626565
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Entity Type | Individual
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Provider Name | VICTORIA ELISE MAZZELLA MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 1095 WHIPPOORWILL LN
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City | NAPLES
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State | FL
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Zip | 34105-3800
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Country | US
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Telephone | 239-235-0517
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Fax |
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Provider Business Mailing Address
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Address Line | 118 SW 22ND AVE
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City | CAPE CORAL
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State | FL
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Zip | 33991-1382
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Country | US
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Telephone | 239-565-6103
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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 | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | ME162828
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License Number State | FL
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