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General NPI Number Information
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NPI Number | 1962356006
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Entity Type | Individual
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Provider Name | DANIELA DEBERNARDO
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Gender |
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 1270 SW MAIN BLVD
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City | LAKE CITY
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State | FL
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Zip | 32025-6684
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Country | US
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Telephone | 386-752-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 5009 MAIN ST
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City | STRATFORD
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State | CT
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Zip | 06614-8803
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6785
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT26821
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License Number State | FL
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