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General NPI Number Information
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NPI Number | 1861469132
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Entity Type | Individual
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Provider Name | SHERVIN KARIMPOUR M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/04/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3501 JOHNSON ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-5421
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Country | US
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Telephone | 954-987-2000
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Fax | 954-437-6628
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Provider Business Mailing Address
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Address Line | 17333 LA GRANGE RD STE 100
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City | TINLEY PARK
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State | IL
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Zip | 60487-7510
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Country | US
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Telephone | 708-448-9393
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Fax | 708-448-7530
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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 | ME95204
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 036103808
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License Number State | IL
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