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General NPI Number Information
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NPI Number | 1881852853
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Entity Type | Individual
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Provider Name | ANJALI GUPTA MD
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Gender | Female
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 937 N SPRING GARDEN AVE
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City | DELAND
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State | FL
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Zip | 32720-2560
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Country | US
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Telephone | 386-736-1948
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Fax | 386-736-2784
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Provider Business Mailing Address
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Address Line | PO BOX 9671
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City | DAYTONA BEACH
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State | FL
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Zip | 32120-9671
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Country | US
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Telephone | 386-676-7130
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Fax | 386-676-7125
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME87066
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License Number State | FL
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