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General NPI Number Information
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NPI Number | 1952289258
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Entity Type | Individual
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Provider Name | AMBRIELLE PAUL
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Gender | Female
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 11794 US HIGHWAY 301 STE 102
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City | DADE CITY
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State | FL
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Zip | 33525-6024
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Country | US
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Telephone | 352-437-3358
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Fax |
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Provider Business Mailing Address
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Address Line | 8045 E WINDSONG ST
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City | FLORAL CITY
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State | FL
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Zip | 34436-2054
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Country | US
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Telephone | 863-446-3356
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA32608
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License Number State | FL
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