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General NPI Number Information
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NPI Number | 1871758284
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Entity Type | Organization
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Legal Business Name | COASTAL FLORIDA HOSPITALIST PL
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 10/27/2008
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Provider Practice Location Address
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Address Line | 4201 BELFORT RD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1431
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Country | US
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Telephone | 832-651-0323
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Fax |
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Provider Business Mailing Address
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Address Line | 683 CANDLEBARK DR
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City | JACKSONVILLE
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State | FL
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Zip | 32225-5361
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Country | US
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Telephone | 832-651-0323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHIDI U. UCHE
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Credential | MD
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Telephone | 832-651-0323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME97989
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License Number State | FL
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