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General NPI Number Information
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NPI Number | 1952723785
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Entity Type | Individual
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Provider Name | SANJAY PATEL PTA
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Gender | Male
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Dates
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Enumeration Date | 01/14/2014
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 4641 OLD CANOE CREEK RD
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City | SAINT CLOUD
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State | FL
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Zip | 34769-1550
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Country | US
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Telephone | 407-892-7344
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Fax |
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Provider Business Mailing Address
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Address Line | 9037 HORIZON POINTE TRL
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City | WINDERMERE
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State | FL
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Zip | 34786-8424
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Country | US
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Telephone | 949-466-9296
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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 | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | PTA 23648
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTA23648
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License Number State | FL
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