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General NPI Number Information
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NPI Number | 1861818510
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Entity Type | Individual
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Provider Name | MADHAVI REDDY RAVI M.D
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Gender | Female
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 17345 SE 109TH TERRACE RD
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8930
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Country | US
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Telephone | 352-751-4885
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Fax | 352-732-2440
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Provider Business Mailing Address
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Address Line | 1901 SE 18TH AVE STE 400
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City | OCALA
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State | FL
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Zip | 34471-8213
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Country | US
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Telephone | 352-732-8905
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Fax | 342-732-2440
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 144008
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License Number State | FL
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