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General NPI Number Information
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NPI Number | 1922004001
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Entity Type | Individual
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Provider Name | FE V.S.J. PANCITO M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 1430 S PINE ST
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City | MELBOURNE
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State | FL
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Zip | 32901-3119
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Country | US
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Telephone | 321-952-0898
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 534595
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City | ATLANTA
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State | GA
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Zip | 30353-4595
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Country | US
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Telephone |
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0035608
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | ME35608
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License Number State | FL
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