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General NPI Number Information
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NPI Number | 1891358792
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Entity Type | Organization
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Legal Business Name | AMBULATORY ENDOSCOPY CENTER OF CENTRAL FLORIDA, INC.
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 04/16/2019
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Provider Practice Location Address
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Address Line | 515 W STATE ROAD 434 STE 105
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City | LONGWOOD
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State | FL
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Zip | 32750-5161
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Country | US
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Telephone | 407-260-6000
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Fax | 407-260-2133
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Provider Business Mailing Address
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Address Line | 9500 S DADELAND BLVD STE 200
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City | MIAMI
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State | FL
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Zip | 33156-2866
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Country | US
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Telephone | 305-468-4185
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Fax | 305-675-3378
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | OLEN ANDREW GILES
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Credential | MD
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Telephone | 305-468-4185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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