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General NPI Number Information
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NPI Number | 1902004161
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Entity Type | Organization
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Legal Business Name | PULMONARY PRACTICE OF ORLANDO, P.A
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | 1697 LAKE BALDWIN LN
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City | ORLANDO
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State | FL
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Zip | 32814-6722
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Country | US
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Telephone | 407-515-8585
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Fax | 407-515-8584
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Provider Business Mailing Address
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Address Line | PO BOX 568671
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City | ORLANDO
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State | FL
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Zip | 32856-8671
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Country | US
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Telephone | 407-515-8585
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Fax | 407-515-8584
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Authorized Official
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Title or Position | CRENTIALING
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Name | CAROL PEREZ
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Credential |
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Telephone | 407-515-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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