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NPI 1861703696

NPI 1861703696 : ANGEL HARPER M.D., M.S. : JACKSONVILLE, FL

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General NPI Number Information
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    NPI Number           |    1861703696
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    Entity Type          |    Individual 
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    Provider Name        |    ANGEL HARPER M.D., M.S.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/25/2010
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    Last Update Date     |    12/11/2014
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Provider Practice Location Address
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    Address Line         |    820 PRUDENTIAL DR SUITE 713
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32207-8210
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    Country              |    US
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    Telephone            |    904-396-5682
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2048 EMERALD GREEN RD 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32246-0588
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    Country              |    US
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    Telephone            |    
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    ME 119351
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    License Number State |    FL
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Taxonomy #3
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    70970
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    License Number State |    GA
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