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General NPI Number Information
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NPI Number | 1962483289
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Entity Type | Individual
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Provider Name | DAVID A DISANTO MD
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Gender | Male
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 8333 N DAVIS HWY WEST FLORIDA MEDICAL CENTER CLINIC PA
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City | PENSACOLA
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State | FL
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Zip | 32514-6049
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Country | US
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Telephone | 850-474-8319
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Fax | 850-969-2958
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Provider Business Mailing Address
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Address Line | 4901 MARKET PLACE RD
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City | PENSACOLA
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State | FL
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Zip | 32504-8986
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Country | US
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Telephone | 850-474-8319
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Fax | 850-969-2958
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME0078432
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License Number State | FL
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