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General NPI Number Information
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NPI Number | 1962377929
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Entity Type | Organization
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Legal Business Name | PAM PHYSICIAN ENTERPRISE
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 1730 MAYO DR
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City | TAVARES
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State | FL
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Zip | 32778-4308
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Country | US
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Telephone | 352-525-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 1828 GOOD HOPE RD STE 102 ATTN LEGAL DEPT
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City | ENOLA
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State | PA
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Zip | 17025-1203
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Country | US
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Telephone | 717-731-9660
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY MISITANO
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Credential |
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Telephone | 717-731-9660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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